Individual
MISS COLLEEN PATRICIA LASSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
8380 GEDDES RD, YPSILANTI, MI 48198-9404
(734) 547-7600
(734) 879-4949
Mailing address
8380 GEDDES RD, YPSILANTI, MI 48198-9404
(734) 547-7600
(734) 879-4949
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057002577
IL
224Z00000X
Occupational Therapy Assistant
Primary
5202001611
MI
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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