Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT 15888 | FL |
NPI | 1326245184 |
---|---|
Provider Name | Donna L. Scudder |
First Address | Venice, FL 34293-5416 |
Second Address | Venice, FL 34285-3652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 21/08/2014 |