Individual
MRS. TIANNA LYNN BURNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A
Contact information
Practice address
4554 W 48TH ST, FREMONT, MI 49412-8721
(231) 924-9295
Mailing address
1055 SHOREWALK LN, WHITEHALL, MI 49461-9148
(231) 893-1265
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202006962
MI
Other
Enumeration date
01/20/2012
Last updated
01/20/2012
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