Individual
ELISSA A DITZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
10550 N PARMA RD, SPRINGPORT, MI 49284-9720
(517) 262-1884
Mailing address
151 2ND ST, SPRING ARBOR, MI 49283-9647
(517) 750-1900
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008380
MI
Other
Enumeration date
10/22/2012
Last updated
06/21/2021
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