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Gayathri Ethiraj

Occupational Therapist in Detroit, MI. Individual provider (NPI-1).

NPI number1114488178
StatusActive
Last updated in NPPESMar 30, 2019

Details

NPI
1114488178
Entity type
Individual (NPI-1)
Name
Gayathri Ethiraj
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 30, 2019
Last updated
Mar 30, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist5201007043MIYes

Practice location

15311 Schaefer Hwy
Detroit, MI 48227-3337

Phone 313-879-4775

Mailing address

452 Princeton Dr
Canton, MI 48188-1028

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