Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT00000973 | WA |
NPI | 1295030849 |
---|---|
Provider Name | Barbara Karen Struck |
First Address | Walla Walla, WA 99362-2515 |
Second Address | Walla Walla, WA 99362-4116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2011 |
Last Update Date | 26/11/2018 |