NPI | 1023533312 |
---|---|
Former Name | JEANETTE MARIE SCHWAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: MO 2016036932) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2016036932) |
Enumeration Date | 2017-08-07 |
Last Update Date | 2019-04-26 |