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Individual

LINDA ROSEANNE HAYES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTAL

Contact information

Practice address
8481 HOLLY RD, GRAND BLANC, MI 48439-1812
(810) 603-1111
Mailing address
8481 HOLLY RD, GRAND BLANC, MI 48439-1812
(810) 603-1111

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007146
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5202007146
MICHIGAN LICENSE
Enumeration date
07/25/2013
Last updated
07/25/2013
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