NPI | 1710767975 |
---|---|
Former Name | SERENA JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 028433) |
Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
Enumeration Date | 2023-10-04 |
Last Update Date | 2024-08-05 |