| NPI | 1528397999 |
|---|---|
| Former Name | AMY REBECCA WISNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 1366) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: IA 000857) |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2019-10-01 |