NPI | 1669435061 |
---|---|
Former Name | DEANDREA VONTRESE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT9334) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: GA OT004295) |
Enumeration Date | 2006-04-08 |
Last Update Date | 2014-01-15 |