Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 07502 | MD |
NPI | 1083015051 |
---|---|
Provider Name | Julie Williford |
First Address | Columbia, MD 21046-1143 |
Second Address | Columbia, MD 21046-1143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2014 |
Last Update Date | 23/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07502 | OCCUPATIONAL THERAPY LICENSE (01) | MD |