Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | U2-0001289 | DE |
NPI | 1023558665 |
---|---|
Provider Name | Erica Drayton |
First Address | Lewes, DE 19958-1269 |
Second Address | Lewes, DE 19958-1269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2017 |
Last Update Date | 01/03/2017 |