Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT10856 | FL |
N | 225XR0403X | Driving and Community Mobility | OT10856 | FL |
NPI | 1952748428 |
---|---|
Provider Name | Mr. Sean Taylor Yarbrough |
First Address | Brandon, FL 33511-8362 |
Second Address | Brandon, FL 33511-8362 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2013 |
Last Update Date | 21/04/2014 |