NPI | 1215450028 |
---|---|
Former Name | JESSICA OLSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO OT.0005542) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ 7090) |
Enumeration Date | 2017-07-24 |
Last Update Date | 2023-01-13 |