NPI | 1992240832 |
---|---|
Former Name | TA'NIQUA JESSICA NEWKIRK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 377218) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 18169) |
225X00000X Occupational Therapist (Licence: SC 5819) | |
Enumeration Date | 2017-01-02 |
Last Update Date | 2022-08-21 |