Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 3055 | AZ |
N | 225XH1200X | Occupational Therapist - Hand | 3055 | AZ |
NPI | 1073705620 |
---|---|
Provider Name | Jeffrey A Winslow |
First Address | Nashville, TN 37204-3708 |
Second Address | Nashville, TN 37204-3708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2007 |
Last Update Date | 26/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q018364 | (05) | TN |