Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 5025 | AZ |
NPI | 1003189572 |
---|---|
Provider Name | Miss Danielle Reuben |
First Address | Milford, DE 19963-6132 |
Second Address | Fort Lauderdale, FL 33301-1129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2012 |
Last Update Date | 14/02/2012 |