Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT8345 | FL |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT8345 | FL |
NPI | 1255599833 |
---|---|
Provider Name | Andre Lynne Erlandson |
First Address | Homosassa, FL 34446-1465 |
Second Address | Homosassa, FL 34446-1465 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 30/05/2008 |