Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 3689 | AL |
NPI | 1023447307 |
---|---|
Provider Name | Kaitlin Terry |
First Address | Huntsville, AL 35801-4306 |
Second Address | Huntsville, AL 35801-4306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2013 |
Last Update Date | 06/11/2013 |