Individual
GENIEVE MITRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8005
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201013190
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201013190
STATE OF MICHIGAN LICENSE
MI
Enumeration date
05/02/2023
Last updated
05/02/2023
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