Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 056-004940 | IL |
NPI | 1235121823 |
---|---|
Provider Name | Amie Daryanani |
First Address | Apo, AE 09126-3865 |
Second Address | Wright Patterson Afb, OH 45433-5529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 16/04/2018 |