Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1205225901 |
---|---|
Provider Name | Elizabeth Budelier |
First Address | Davenport, IA 52804-2024 |
Second Address | Davenport, IA 52804-2024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2015 |
Last Update Date | 19/01/2015 |