| NPI | 1639223282 |
|---|---|
| Former Name | TARA LYN LAVY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: HI OT-947) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: AR OTR1131) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2016-02-23 |