| NPI | 1104467869 |
|---|---|
| Former Name | JESSICA C BOSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AL 2872) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 18368) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2021-01-08 |