| NPI | 1508056870 |
|---|---|
| Former Name | VICKI LYNNE TYNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 103542) |
| Additional Taxonomies | 225XP0019X Occupational Therapist Physical Rehabilitation |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2021-05-27 |