Individual
MRS. DANIELLE MARIE HACKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2125 43RD ST SE # APTK-12, GRAND RAPIDS, MI 49508-3773
(609) 802-2100
Mailing address
2125 43RD ST SE # APTK-12, GRAND RAPIDS, MI 49508-3773
(609) 802-2100
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5201009904
MI
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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