Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 959 | WV |
NPI | 1003210337 |
---|---|
Provider Name | Emily Kearns |
First Address | Dunbar, WV 25064-1711 |
Second Address | Winfield, WV 25213-9347 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2014 |
Last Update Date | 15/10/2014 |