| NPI | 1710439948 |
|---|---|
| Former Name | SHEA MADISON PETREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: AR OTR2995) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: MD 2018037861) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2023-01-20 |