Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | U2-0002102 | DE |
NPI | 1023622537 |
---|---|
Provider Name | Mai Hall |
First Address | Milford, DE 19963-1039 |
Second Address | Milford, DE 19963-1039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2020 |
Last Update Date | 02/09/2020 |