Individual
MS. MARY ELLEN BARDYGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
6470 ALDEN DR, ORCHARD LAKE, MI 48324-2006
(248) 363-4121
Mailing address
6470 ALDEN DR, ORCHARD LAKE, MI 48324-2006
(248) 363-4121
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201003179
MI
Other
Enumeration date
03/07/2018
Last updated
03/17/2018
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