Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201001821 | MI |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201001821 | MI |
NPI | 1255836581 |
---|---|
Provider Name | Deborah Taylor |
First Address | Cadillac, MI 49601-2385 |
Second Address | Cadillac, MI 49601-2385 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2018 |
Last Update Date | 28/03/2018 |