Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 20877 | CA |
NPI | 1003442963 |
---|---|
Provider Name | Ann Culver |
First Address | Grandview, MO 64030-3722 |
Second Address | Grandview, MO 64030-1884 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2020 |
Last Update Date | 22/03/2020 |