Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT-1534 | WY |
NPI | 1033710470 |
---|---|
Provider Name | Erica Kaylynne Strautman |
First Address | Cheyenne, WY 82007-2042 |
Second Address | Cheyenne, WY 82007-3057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2020 |
Last Update Date | 03/11/2020 |