Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 10483 | FL |
NPI | 1003156639 |
---|---|
Provider Name | Betty Garza |
First Address | West Palm Beach, FL 33406-5640 |
Second Address | West Palm Beach, FL 33406-5640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2013 |
Last Update Date | 19/02/2013 |