Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT60343906 | WA |
NPI | 1093056822 |
---|---|
Provider Name | Amanda Martini |
First Address | Richland, WA 99352-4211 |
Second Address | Richland, WA 99352-4211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2013 |
Last Update Date | 04/03/2013 |