Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 6350 | CA |
NPI | 1003266271 |
---|---|
Provider Name | Darcy Carter |
First Address | Wilsonville, OR 97070-9697 |
Second Address | Weed, CA 96094-2332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2016 |
Last Update Date | 17/06/2016 |