NPI | 1730637646 |
---|---|
Former Name | HALEY LARAE LARSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 1496) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 105234) |
Enumeration Date | 2016-09-20 |
Last Update Date | 2020-09-29 |