NPI | 1396799789 |
---|---|
Former Name | STACEY A GIBLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 103316) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SD 0649) |
225X00000X Occupational Therapist (Licence: NV 0782) | |
Enumeration Date | 2006-05-20 |
Last Update Date | 2016-11-02 |