Individual
MS. SHELLY ANN THATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3965 MAPLE BLVD, WEST BLOOMFIELD, MI 48323-1263
(248) 363-6144
Mailing address
3965 MAPLE BLVD, WEST BLOOMFIELD, MI 48323-1263
(248) 363-6144
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202001915
MI
Other
Enumeration date
10/27/2011
Last updated
02/14/2013
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