| NPI | 1457976391 |
|---|---|
| Former Name | GRACE LYNN CARLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: ME OA3810) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NH 0831) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2021-07-01 |