NPI | 1528437688 |
---|---|
Former Name | VICTORIA FORTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ME OT3638) |
Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 117167) |
Enumeration Date | 2015-09-18 |
Last Update Date | 2019-09-11 |