Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 277 | MT |
NPI | 1003858325 |
---|---|
Provider Name | Mrs. Amy Ann Moran |
First Address | Helena, MT 59601-5929 |
Second Address | Helena, MT 59601-4915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0347548 | (05) | MT |