Individual
BARBARA FANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1743 BROOKLINE ST, CANTON, MI 48187-3107
(734) 476-4386
Mailing address
1743 BROOKLINE ST, CANTON, MI 48187-3107
(734) 476-4386
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201001668
MI
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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