Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 11878 | FL |
NPI | 1023350220 |
---|---|
Provider Name | Leanne Skinner |
First Address | Port Saint Lucie, FL 34953-4241 |
Second Address | Port Saint Lucie, FL 34953-4241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2013 |
Last Update Date | 26/03/2013 |