Individual
REBECCA DETGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1299 S THOMAS RD, BAD AXE, MI 48413-9710
(989) 551-5003
Mailing address
2084 E MAIN ST, UBLY, MI 48475-9726
(989) 551-5003
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202008613
MI
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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