Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CA2400X | Assistive Technology Practitioner | ||
Y | 225X00000X | Occupational Therapist | OT10448 | FL |
N | 225XE0001X | Environmental Modification | ||
N | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1194215459 |
---|---|
Provider Name | Elisa Wern |
First Address | Gainesville, FL 32653-1735 |
Second Address | Gainesville, FL 32653-1735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2018 |
Last Update Date | 12/05/2018 |