Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 884 | NE |
NPI | 1023672938 |
---|---|
Provider Name | Mr. Andrew Patrick Flaherty |
First Address | Grand Island, NE 68801-6441 |
Second Address | Grand Island, NE 68801-8823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2019 |
Last Update Date | 25/04/2019 |