Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 5202007651 | MI |
NPI | 1003221805 |
---|---|
Provider Name | Lucy Ann Arnold |
First Address | Mesick, MI 49668 |
Second Address | Mesick, MI 49668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2014 |
Last Update Date | 01/07/2014 |