Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0200X | Occupational Therapist - Pediatrics | 131535 | KY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 5090-26 | WI |
NPI | 1023381118 |
---|---|
Provider Name | Abby R Huffman |
First Address | Waukesha, WI 53186-6824 |
Second Address | New Berlin, WI 53151-3743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2012 |
Last Update Date | 15/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100204350 | (05) | KY |