Individual
CORRINA RAE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 CHERRY ST SE # 1, GRAND RAPIDS, MI 49503-4608
(616) 685-4687
Mailing address
6704 N WENTWARD CT, HUDSONVILLE, MI 49426-9251
(906) 290-4389
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225800000X
Recreation Therapist
83895
MI
225X00000X
Occupational Therapist
Primary
5201013645
MI
Other
Enumeration date
09/06/2018
Last updated
10/17/2023
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