Individual
MRS. CRYSTAL MARIE SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. OTR/L
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 685-6264
Mailing address
1411 S FERN DR, MT PROSPECT, IL 60056-4526
(616) 540-2031
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007455
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649527946
—
MI
Enumeration date
08/06/2012
Last updated
04/16/2018
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