Individual
KAYLA MIELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2510 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49504-8042
(616) 735-6082
Mailing address
102 UNION AVE SE APT 2, GRAND RAPIDS, MI 49503-4495
(517) 449-5225
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009148
MI
Other
Enumeration date
03/14/2018
Last updated
03/17/2018
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