Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA 13177 | FL |
NPI | 1023444254 |
---|---|
Provider Name | Katherine Marie Chandler |
First Address | Tampa, FL 33625-4022 |
Second Address | Tampa, FL 33625-4022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2013 |
Last Update Date | 19/09/2013 |