| NPI | 1144707738 |
|---|---|
| Former Name | MISTY MICHELLE FERGASON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: GA 2432) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TN 2300) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2023-06-29 |