Individual
STEPHANIE SURINCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
721 W CHELSEA CIR, DAVISON, MI 48423-1261
(810) 965-1508
Mailing address
721 W CHELSEA CIR, DAVISON, MI 48423-1261
(810) 965-1508
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
5202006006
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5202006006
COTA LICENSE
MI
Enumeration date
10/05/2015
Last updated
10/05/2015
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