Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT60862592 | WA |
NPI | 1225470826 |
---|---|
Provider Name | Brooke Allen |
First Address | Vancouver, WA 98664-4896 |
Second Address | Fountain Hills, AZ 85268 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2013 |
Last Update Date | 02/08/2018 |