Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT7296 | FL |
N | 225XH1200X | Occupational Therapist - Hand | 1011100418 |
NPI | 1174582514 |
---|---|
Provider Name | Laura Jean Gadberry |
First Address | Jupiter, FL 33477-5062 |
Second Address | Jupiter, FL 33477-5062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4335580001 | PALMETTO (01) | FL |
R5M | BCBS (01) | FL |