| NPI | 1780954339 |
|---|---|
| Former Name | MARISA MAE GRUNKLEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 124389) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: CO 3297) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: MT 6152) | |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2024-04-24 |