Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 089474 | IA |
NPI | 1285123406 |
---|---|
Provider Name | Bridget Marie Kohn-Lindquist |
First Address | Omaha, NE 68106-3028 |
Second Address | Sioux City, IA 51104-1518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2018 |
Last Update Date | 02/05/2018 |