Individual
SHELBY LAURA RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 N MAIN ST, LAKE CITY, MI 49651-5102
(231) 295-1196
Mailing address
4249 E HERRICK RD, CLARE, MI 48617-9325
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
86207
MI
Other
Enumeration date
05/12/2022
Last updated
10/01/2024
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