| NPI | 1346601200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY TUCKER Cota 855-584-5845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: KY BOTOTA00217475) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2022-03-10 |