NPI | 1053787572 |
---|---|
Former Name | KELSEY WEIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201009867) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KS 17-03012) |
Enumeration Date | 2015-08-19 |
Last Update Date | 2018-06-06 |