NPI | 1053871368 |
---|---|
Former Name | KELLY LEE PIEPENBRINK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IN 31007250A) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: IN RBT-17-44326) |
Enumeration Date | 2019-03-22 |
Last Update Date | 2023-11-14 |