Individual
MRS. DANIELLE N BOOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
3351 EAGLE RUN DR NE, GRAND RAPIDS, MI 49525-7070
(616) 365-8920
(616) 365-8971
Mailing address
2542 RAYMOND AVE SE, GRAND RAPIDS, MI 49507-3927
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007526
MI
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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