| NPI | 1427704337 |
|---|---|
| Former Name | AUDREY LYNNE GROLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 16722) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2022006857) |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2024-07-25 |