Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 979563 | OR |
NPI | 1154860419 |
---|---|
Provider Name | Joy Hallett |
First Address | Wilsonville, OR 97070-9697 |
Second Address | Wilsonville, OR 97070-9697 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2017 |
Last Update Date | 20/02/2017 |