| NPI | 1457959710 |
|---|---|
| Former Name | MADISON ALEXANDRA FAKOURI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: LA 332852) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 121234) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 121234) | |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2024-02-29 |