Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA 8044 | FL |
NPI | 1023563350 |
---|---|
Provider Name | Lisa Schenk |
First Address | Jupiter, FL 33458-5694 |
Second Address | Jupiter, FL 33458-5694 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2016 |
Last Update Date | 16/08/2016 |