Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA 13848 | FL |
NPI | 1013152347 |
---|---|
Provider Name | Cristin Anne Eller |
First Address | Tallahassee, FL 32308-4473 |
Second Address | Tallahassee, FL 32308-4473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2008 |
Last Update Date | 10/09/2014 |