Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT18407 | FL |
N | 225XE0001X | Environmental Modification | OT18407 | FL |
NPI | 1003497207 |
---|---|
Provider Name | Dunrey A Larose |
First Address | Orlando, FL 32806-5570 |
Second Address | Orlando, FL 32806-5570 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2021 |
Last Update Date | 19/04/2021 |