| NPI | 1811541444 |
|---|---|
| Former Name | LACEY JORDAN HUNTINGTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: MT OTP-OT-LIC-6882) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2020-01-08 |