NPI | 1124274550 |
---|---|
Former Name | JESSICA LEE TEZYK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 010781-1) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA OC008366) |
Enumeration Date | 2008-08-18 |
Last Update Date | 2011-12-07 |