Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT8200 | FL |
N | 225XG0600X | Occupational Therapist - Gerontology | OT8200 | FL |
NPI | 1043464027 |
---|---|
Provider Name | Mr. Noel Lee Velarde |
First Address | Flint, MI 48532-3233 |
Second Address | Flint, MI 48532-3233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2008 |
Last Update Date | 04/11/2008 |