Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA00665 | RI |
NPI | 1013341783 |
---|---|
Provider Name | Heidi M Eklund |
First Address | Exeter, RI 02822-3735 |
Second Address | Exeter, RI 02822-3735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2013 |
Last Update Date | 29/08/2013 |