Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 543579 | OR |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 543579 | OR |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 543579 | OR |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 543579 | OR |
NPI | 1467688077 |
---|---|
Provider Name | Laury Ann Lee-Tosh |
First Address | Medford, OR 97504-8173 |
Second Address | Ashland, OR 97520-1200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2009 |
Last Update Date | 10/06/2009 |