NPI | 1134457831 |
---|---|
Former Name | AMANDA ROSE WEIGLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225XG0600X Occupational Therapist, Gerontology (Licence: NC 7261) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT 13076) |
225X00000X Occupational Therapist (Licence: TX 113212) | |
Enumeration Date | 2009-11-18 |
Last Update Date | 2021-11-09 |