Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0615 | NV |
NPI | 1003030339 |
---|---|
Provider Name | Alicia Marie Schwarz |
First Address | Las Vegas, NV 89107-1103 |
Second Address | Las Vegas, NV 89123-1902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 02/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003030339 | (05) | NV |