Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 3905 | FL |
NPI | 1003478447 |
---|---|
Provider Name | Monika Sao |
First Address | Maitland, FL 32751-4979 |
Second Address | Maitland, FL 32751-4979 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2019 |
Last Update Date | 06/07/2019 |