| NPI | 1891562914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE FREDERICK Co Owner 870-270-7963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| Enumeration Date | 2023-12-08 |
| Last Update Date | 2023-12-08 |