Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 17530 | FL |
NPI | 1003274176 |
---|---|
Provider Name | Danielle Marie Beatty |
First Address | Gainesville, FL 32606-2006 |
Second Address | Gainesville, FL 32606-2006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2016 |
Last Update Date | 04/02/2016 |