NPI | 1538212105 |
---|---|
Former Name | COURTNEY IVERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: CT 003334) |
Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: MA 8745) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2013-06-27 |