NPI | 1184106239 |
---|---|
Former Name | HALLIE DEW ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: MO 2018032487) |
Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: WA 00001576) |
Enumeration Date | 2018-09-05 |
Last Update Date | 2018-09-05 |