| NPI | 1750921540 |
|---|---|
| Former Name | JENNIFER DIANE BUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IN 31003876A) |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2020-02-04 |