Individual
KARLY GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
46200 PORT ST, PLYMOUTH, MI 48170-6048
(734) 454-0866
Mailing address
3555 POLK ST, DEARBORN, MI 48124-3835
(734) 740-5303
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5201011401
MI
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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