Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT 10198 | FL |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1932436987 |
---|---|
Provider Name | Becki Ruth Maas |
First Address | Tampa, FL 33618-4201 |
Second Address | Tampa, FL 33618-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2009 |
Last Update Date | 12/11/2009 |