Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 110687 | IA |
N | 225XP0200X | Occupational Therapist - Pediatrics | 110687 | IA |
NPI | 1013686948 |
---|---|
Provider Name | Amy Joyce Davis |
First Address | Ames, IA 50010-8768 |
Second Address | Ames, IA 50010-8768 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2021 |
Last Update Date | 09/02/2022 |