NPI | 1578770418 |
---|---|
Former Name | SHEMAINE LYNISE BULLARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ 5157) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056.008750) |
225X00000X Occupational Therapist (Licence: MI 5201005840) | |
225X00000X Occupational Therapist (Licence: IN 31000917A) | |
225X00000X Occupational Therapist (Licence: FL 17586) | |
Enumeration Date | 2007-05-17 |
Last Update Date | 2018-03-17 |