NPI | 1326438219 |
---|---|
Former Name | KELSEY PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: CA 12038) |
Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation |
Enumeration Date | 2015-01-29 |
Last Update Date | 2015-01-29 |