Individual
STEPHANIE GERWOLLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28555 ORCHARD LAKE RD, FARMINGTON HILLS, MI 48334-2973
(248) 788-4300
Mailing address
28555 ORCHARD LAKE RD, FARMINGTON HILLS, MI 48334-2973
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007505
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16299316815
LIFE SKILLS VILLAGE PLLC.
MI
Enumeration date
11/26/2013
Last updated
11/26/2013
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