Individual
KELLY RENE BOUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,OTR
Contact information
Practice address
1080 E STERNBERG RD, MUSKEGON, MUSKEGON, MI 49444-8796
(231) 799-2200
Mailing address
809 E FILER ST, LUDINGTON, LUDINGTON, MI 49431-2210
(231) 233-3272
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201006679
MI
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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