Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT2191 | FL |
NPI | 1023253242 |
---|---|
Provider Name | Linda D. Jones |
First Address | Port Saint Lucie, FL 34952-3405 |
Second Address | Port Saint Lucie, FL 34952-3405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2008 |
Last Update Date | 28/11/2011 |