Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA00949 | RI |
NPI | 1013503077 |
---|---|
Provider Name | Brandie Lee Flesia |
First Address | Portsmouth, RI 02871-1364 |
Second Address | Portsmouth, RI 02871-1364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2020 |
Last Update Date | 14/12/2020 |