Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OC00000713 | WA |
NPI | 1013465459 |
---|---|
Provider Name | Lorene Morris |
First Address | Naches, WA 98937 |
Second Address | Yakima, WA 98902-3521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2016 |
Last Update Date | 14/09/2016 |