NPI | 1790328052 |
---|---|
Former Name | STEPHANIE LORRAINE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA OT009361) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ OTH-007954) |
Enumeration Date | 2019-10-18 |
Last Update Date | 2024-11-11 |