Individual
MARIAH ELIZABETH THELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
620 N 2ND ST, CARSON CITY, MI 48811-9790
(989) 584-6100
Mailing address
210 W WASHINGTON ST, PEWAMO, MI 48873-5109
(989) 640-9587
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202010245
MI
Other
Enumeration date
01/16/2025
Last updated
01/16/2025
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