| NPI | 1174990204 |
|---|---|
| Former Name | KATELYN JESSICA DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 11591) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 115886) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |