Individual
MRS. MICHELLE ELAINE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
770 N 075 E, LAGRANGE, IN 46761-9359
(260) 463-7445
Mailing address
2706 CEDARWOOD CT, GOSHEN, IN 46526-1055
(260) 908-3565
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001220A
IN
Other
Enumeration date
06/22/2007
Last updated
01/17/2012
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