Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 99027443A | IN |
NPI | 1013114107 |
---|---|
Provider Name | Courtney D Price |
First Address | Evansville, IN 47725-8137 |
Second Address | Newburgh, IN 47630-2528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 08/07/2007 |