NPI | 1831755024 |
---|---|
Former Name | SUZANNE OVERTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IL 056012993) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096003862) |
Enumeration Date | 2019-05-14 |
Last Update Date | 2023-08-09 |