Individual
JONATHAN GASSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
6198 WINCLIFF DR, WEST BLOOMFIELD, MI 48322-2099
(248) 915-8592
(248) 328-2941
Mailing address
6198 WINCLIFF DR, WEST BLOOMFIELD, MI 48322-2099
(248) 915-8592
(248) 328-2941
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009976
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201009976
OCCUPATIONAL THERAPIST LICENSE
MI
Enumeration date
03/21/2019
Last updated
11/27/2023
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