Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 00643 | IA |
NPI | 1265530125 |
---|---|
Provider Name | Laurie Kay Stonewall-Johnson |
First Address | Iowa City, IA 52245-9509 |
Second Address | Iowa City, IA 52245-9509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 15/01/2013 |