NPI | 1770122368 |
---|---|
Former Name | JESSICA SCHELIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031660) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 022846) |
Enumeration Date | 2019-12-30 |
Last Update Date | 2024-03-21 |