NPI | 1063904548 |
---|---|
Former Name | KELSY MARIE TRACEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IN 31006653A) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IN 99086161A) |
Enumeration Date | 2018-05-31 |
Last Update Date | 2021-07-22 |