Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 11548514-4201 | UT |
NPI | 1003454042 |
---|---|
Provider Name | Katherine Marie Artery |
First Address | Lander, WY 82520-3055 |
Second Address | Lander, WY 82520-3455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2019 |
Last Update Date | 06/07/2020 |