NPI | 1225481781 |
---|---|
Former Name | MARIE K CHAMPAGNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: AL OT4563) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OT4563) |
Enumeration Date | 2016-07-20 |
Last Update Date | 2022-08-16 |