Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 103782 | TX |
NPI | 1134551294 |
---|---|
Provider Name | Julianna Amspoker |
First Address | Orlando, FL 32817-8373 |
Second Address | Orlando, FL 32817-8373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2013 |
Last Update Date | 31/07/2013 |