Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 32003271A | IN |
NPI | 1013404888 |
---|---|
Provider Name | Kumiko Peoples |
First Address | Louisville, KY 40206-2513 |
Second Address | New Albany, IN 47150-9426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2018 |
Last Update Date | 17/04/2018 |