NPI | 1396082723 |
---|---|
Former Name | AMANDA NOWAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 10707) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CT 003999) |
Enumeration Date | 2013-01-04 |
Last Update Date | 2015-05-27 |