Individual
MRS. KOLLEEN FAYE O'LEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
1495 FORT ST, WYANDOTTE, MI 48192-3036
(734) 330-1560
Mailing address
40655 W 10 MILE RD, NOVI, MI 48375-3504
(248) 478-0765
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902009245
MI
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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