NPI | 1962842609 |
---|---|
Former Name | STEPHANIE NICOLE GREEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WV 1648) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WV LPT357) |
Enumeration Date | 2013-06-26 |
Last Update Date | 2020-03-25 |