Individual
KATIE MARIE MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16001 WEST NINE MILE RD., SOUTHFIELD, MI 48075
(248) 948-3465
Mailing address
2114 WOODWIND CT., CANTON, MI 48188
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201001760
MI
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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