Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT2590 | FL |
NPI | 1336377373 |
---|---|
Provider Name | Marla Hinkle |
First Address | Melbourne, FL 32934-8235 |
Second Address | Melbourne, FL 32934-8235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2009 |
Last Update Date | 29/06/2009 |