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Individual

TRACY YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
1310 E BELTLINE AVE SE, SUITE 230, GRAND RAPIDS, MI 49506-4304
(616) 526-8947
(616) 526-8952
Mailing address
1310 E BELTLINE AVE SE, SUITE 230, GRAND RAPIDS, MI 49506-4304
(616) 526-8947
(616) 526-8952

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
5201004439
MI
225XP0200X
Pediatric Occupational Therapist
Primary
5201004439
MI

Other

Enumeration date
09/15/2015
Last updated
09/15/2015
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