NPI | 1356685382 |
---|---|
Former Name | KRISTINA STAFFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 118743) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 2729) |
Enumeration Date | 2012-11-15 |
Last Update Date | 2018-10-15 |