| NPI | 1346751476 | 
|---|---|
| Former Name | MADDIE MAE COFFMAN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NE 1773) | 
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology (Licence: NE 1773) | 
| Enumeration Date | 2017-10-16 | 
| Last Update Date | 2017-10-16 |