NPI | 1841721875 |
---|---|
Former Name | BRIANNA PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: DC OT010001515) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: HI OT-1619) |
225X00000X Occupational Therapist (Licence: VA 0119007191) | |
Enumeration Date | 2017-03-22 |
Last Update Date | 2021-12-02 |