Individual
HOLLY ANNELISE OMILJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 253-2434
Mailing address
5041 CLEAR RIDGE DR SE, ADA, MI 49301-8347
(616) 389-4210
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009415
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730133463
—
MI
Enumeration date
03/07/2018
Last updated
03/17/2018
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