Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA14448 | FL |
NPI | 1013388115 |
---|---|
Provider Name | Chelsea Lincoln |
First Address | Cocoa, FL 32926-5892 |
Second Address | Cocoa, FL 32926-5892 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2015 |
Last Update Date | 14/10/2015 |