| NPI | 1629645205 |
|---|---|
| Former Name | DESIRAE MARIE HYDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: ID OT-2169) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ID OT-2169) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2023-09-29 |