NPI | 1184035099 |
---|---|
Former Name | MARIE VANDERBURG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: IL 057.002761) |
Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: IA 00516) |
Enumeration Date | 2014-05-13 |
Last Update Date | 2014-05-13 |