| NPI | 1144844416 |
|---|---|
| Former Name | MONICA A WIDSTRAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: IN 32002653A) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: IL 057.004010) |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |