Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OC00000974 | WA |
NPI | 1003198490 |
---|---|
Provider Name | Holly Linn Frattaroli |
First Address | Des Moines, WA 98198 |
Second Address | Federal Way, WA 98003-7354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2011 |
Last Update Date | 13/09/2011 |