NPI | 1306934773 |
---|---|
Former Name | JESSICA LYNNE DIGIACOMO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC NCP9297) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NC NCP9297) |
235Z00000X Speech-Language Pathologist, (Licence: NC NCP9297) | |
Enumeration Date | 2006-10-11 |
Last Update Date | 2012-08-07 |