Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT14185 | FL |
N | 225XG0600X | Occupational Therapist - Gerontology | OT004476 | GA |
NPI | 1699907808 |
---|---|
Provider Name | Mr. Nino Richie Chiang Leetian |
First Address | Tampa, FL 33624-3070 |
Second Address | Spring Hill, FL 34608-1305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2009 |
Last Update Date | 09/12/2010 |