Individual
MRS. TAMELA S BROUILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2775 E LANSING DR, EAST LANSING, MI 48823-7755
(517) 332-1616
Mailing address
9587 E VERMONTVILLE HWY, DIMONDALE, MI 48821-8766
(517) 582-0948
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202000777
MI
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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