Doctor Name: | KATHLEEN GRACE |
NPI Number: | 1164614665 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS OTR |
License Number: | |
Business Practice Address: | 27525 Martindale Rd New Hudson, MI - 481659601 |
Business Phone Number: | 3138026926 |
Business Fax Number: | |
Mailing Address: | Po Box 852, SOUTH LYON |
State: | MI |
Postal Code: | 481780852 |
Phone Number: | 3138026926 |
Fax Number: | |
NPI Enumeration Date: | 08/17/2007 |
NPI Last Update Date: | 08/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225XN1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Occupational Therapist |
Taxonomy Specialization: | Neurorehabilitation |
Taxonomy Definition: |