Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT-8350 | FL |
NPI | 1164636080 |
---|---|
Provider Name | Joy Christine Broersma |
First Address | Ocala, FL 34480-7384 |
Second Address | Ocala, FL 34471-9145 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 11/04/2018 |