NPI | 1639539950 |
---|---|
Former Name | KAITLYNN LILLIAN BORETSKY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: SC 5132) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA OC014331) |
Enumeration Date | 2016-02-29 |
Last Update Date | 2024-09-03 |