Individual
JENNIFER MCLELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
709 W SUPERIOR ST, WAYLAND, MI 49348-1226
(269) 792-4440
(269) 792-4475
Mailing address
988 KENMOOR AVE SE, GRAND RAPIDS, MI 49546-3641
(616) 826-0855
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007338
MI
Other
Enumeration date
06/13/2013
Last updated
06/13/2013
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