Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003458696 |
---|---|
Provider Name | Lindsay Chapman |
First Address | Grand Rapids, MI 49546-2431 |
Second Address | Grand Rapids, MI 49546-2431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2019 |
Last Update Date | 15/10/2019 |