Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | A02362 | MD |
NPI | 1003398769 |
---|---|
Provider Name | Jessica Atkinson |
First Address | Brambleton, VA 20148-5739 |
Second Address | Rockville, MD 20852-4803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2018 |
Last Update Date | 29/08/2018 |