Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | MA29461 | FL |
Y | 225X00000X | Occupational Therapist | OT3198 | FL |
N | 2251H1300X | Human Factors | OT3198 | FL |
N | 225XH1300X | Human Factors | OT3198 | FL |
NPI | 1447285044 |
---|---|
Provider Name | Maire Archbold |
First Address | St Petersburg, FL 33713-5225 |
Second Address | St Petersburg, FL 33713-5225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 11/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
888349100 | (05) | FL |