Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT60637962 | WA |
NPI | 1114380029 |
---|---|
Provider Name | Ashley Loera Cardenas |
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 | 30/03/2016 |
Last Update Date | 18/01/2017 |