Individual
MRS. JESSICA SUE BEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
449 QUARTER ST, GLADWIN, MI 48624-1918
(989) 426-3430
Mailing address
803 HEMLOCK ST, MIDLAND, MI 48642-6342
(989) 708-1212
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008148
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201008148
BOARD OF OCCUPATIONAL THERAPY
MI
Enumeration date
01/30/2012
Last updated
01/30/2012
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