| NPI | 1710023239 |
|---|---|
| Former Name | STEPHANIE LYNN GOODE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: IL 056006831) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ 3883) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |