NPI | 1265919419 |
---|---|
Former Name | LESLIE MILAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 216131) |
Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: AR OT-A1382) |
Enumeration Date | 2018-07-20 |
Last Update Date | 2020-05-06 |