Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA17464 | FL |
NPI | 1013541226 |
---|---|
Provider Name | Elizabeth Ann Mckinley |
First Address | Palatka, FL 32177-6858 |
Second Address | Palatka, FL 32177-6858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2020 |
Last Update Date | 26/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OTA17464 | OCCUPATIONAL THERAPY ASSISTANT (01) | FL |