Individual
MIRANDA DEE JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
31 N SAINT JOSEPH AVE, NILES, MI 49120-2207
(269) 687-1885
Mailing address
31 N SAINT JOSEPH AVE, NILES, MI 49120-2207
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201013199
MI
Other
Enumeration date
12/21/2022
Last updated
12/21/2022
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