NPI | 1629369111 |
---|---|
Former Name | KERRY A CLARK POPOVICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AK PHYO2872) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NH 1464) |
225X00000X Occupational Therapist (Licence: ME OT2247) | |
Enumeration Date | 2011-05-02 |
Last Update Date | 2019-05-01 |