| NPI | 1417071382 |
|---|---|
| Former Name | LUCILLE CAROL JENKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CT 4011) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: RI OT01368) |
| Enumeration Date | 2007-03-18 |
| Last Update Date | 2015-06-03 |