Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 225X00000X | Occupational Therapist | OT60735666 | WA |
NPI | 1003250077 |
---|---|
Provider Name | Christine Leah Daly |
First Address | Lakewood, WA 98499-4791 |
Second Address | Lakewood, WA 98499-4791 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2013 |
Last Update Date | 10/07/2017 |