Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 18-1025 | NV |
NPI | 1003247081 |
---|---|
Provider Name | Geoffrey Shih |
First Address | Las Vegas, NV 89146-1126 |
Second Address | Las Vegas, NV 89146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2013 |
Last Update Date | 21/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18-1025 | STATE OF NEVADA BOARD OF OCCUPATIONAL THERAPY (01) | NV |
397892 | NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY (01) |