Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 7476 | FL |
NPI | 1023154416 |
---|---|
Provider Name | Deborah Ann Nelson |
First Address | Palm Harbor, FL 34683-4933 |
Second Address | St Petersburg, FL 33701-4816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |