Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 31004873A | IN |
NPI | 1053541383 |
---|---|
Provider Name | Kirsten Bovee |
First Address | Crown Point, IN 46307-8420 |
Second Address | Crown Point, IN 46307-8420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2009 |
Last Update Date | 10/10/2019 |