Individual
NATALIE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
409 E 9 MILE RD # RE307, FERNDALE, MI 48220-3027
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201011091
MI
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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