Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | ||
Y | 225XG0600X | Occupational Therapist - Gerontology | OT60690145 | WA |
NPI | 1164985727 |
---|---|
Provider Name | Joann M Delvecchio |
First Address | University Place, WA 98466-3203 |
Second Address | Puyallup, WA 98372-6774 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2019 |
Last Update Date | 10/04/2019 |