Individual
PAMUDU DISSANAYAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
700 STEWART RD, MONROE, MI 48162-5304
(734) 240-1820
Mailing address
33278 TALL OAKS CT, FARMINGTON, MI 48336-4548
(248) 787-2973
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010529
MI
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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