Individual
JENNIFER MARIE BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007288
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5202007288
OCCUAPTIONAL THERAPY ASSISTANT
MI
Enumeration date
03/12/2018
Last updated
06/16/2018
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