Individual
DER JUANA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184-1687
(734) 407-2500
Mailing address
35425 W MICHIGAN AVE, WAYNE, MI 48184-1687
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007235
MI
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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