Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | L1563580 | MI |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201005376 | MI |
NPI | 1417188517 |
---|---|
Provider Name | Mrs. Amy Dubey |
First Address | Petoskey, MI 49770-8676 |
Second Address | Petoskey, MI 49770-8676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2009 |
Last Update Date | 10/01/2020 |