NPI | 1023555372 |
---|---|
Former Name | MADELYN JOY FISHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WI 5975 - 26) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 16238) |
225X00000X Occupational Therapist (Licence: MD 07345) | |
Enumeration Date | 2017-01-25 |
Last Update Date | 2017-09-27 |