Individual
MS. MOLLY BUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTL
Contact information
Practice address
7086 8TH AVE, JENISON, MI 49428-9352
(616) 667-9551
(616) 667-9552
Mailing address
7086 8TH AVE, JENISON, MI 49428-9352
(616) 667-9551
(616) 667-9552
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
5201001977
MI
Other
Enumeration date
12/29/2010
Last updated
12/29/2010
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