Individual
BETHANY MICHAELA-CLARK TECSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
219 N MAIN ST, DAVISON, MI 48423-1431
(810) 412-4573
Mailing address
260 BANCROFT ST, IMLAY CITY, MI 48444-1104
(586) 431-2384
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010901
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134125131
—
MI
Enumeration date
07/20/2020
Last updated
10/26/2023
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