| NPI | 1821456179 |
|---|---|
| Former Name | SANDRA G VAN ETTEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 5566) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056011162) |
| 225X00000X Occupational Therapist (Licence: RI OT00481) | |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |