| NPI | 1801388574 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: WV C2208) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: OH OTA004888) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2018-05-30 |