Individual
AEJA KELLY WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-3744
Mailing address
440 ROLAND RD, GROSSE POINTE FARMS, MI 48236-2848
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201006220
MI
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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