NPI | 1104451673 |
---|---|
Former Name | EMILY CLAIRE WALLENHORST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IA 105421) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 6705-026) |
Enumeration Date | 2020-03-05 |
Last Update Date | 2020-09-30 |