Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 12-0253 | NV |
NPI | 1003167024 |
---|---|
Provider Name | Jahana Diiorio |
First Address | Henderson, NV 89074-8154 |
Second Address | Henderson, NV 89074-8154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2012 |
Last Update Date | 27/01/2015 |