Individual
SHAQUEALA HOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18285 E 10 MILE RD, SUITE. 100, ROSEVILLE, MI 48066-5802
(586) 774-5774
Mailing address
5005 BANTRY DR, WEST BLOOMFIELD, MI 48322-1531
(313) 778-5844
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007660
MI
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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