Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 2019025848 | MO |
NPI | 1023662319 |
---|---|
Provider Name | Leah Dawn Murphy |
First Address | Greentop, MO 63546-4223 |
Second Address | Kirksville, MO 63501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2019 |
Last Update Date | 25/07/2019 |