| NPI | 1689068819 |
|---|---|
| Former Name | JACKIE DE PERALTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NE 2438) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IA 087219) |
| 225X00000X Occupational Therapist (Licence: FL OT16835) | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2024-02-20 |