Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | T04868 |
NPI | 1023527157 |
---|---|
Provider Name | Matthew Giarraputo |
First Address | Overland Park, KS 66204-2820 |
Second Address | Overland Park, KS 66204-2820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2017 |
Last Update Date | 20/09/2017 |