Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT22379 | FL |
NPI | 1003588898 |
---|---|
Provider Name | Alyssa Husbands |
First Address | Navarre, FL 32566-7308 |
Second Address | Navarre, FL 32566-7308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2021 |
Last Update Date | 30/09/2021 |