Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 256-026 | WI |
NPI | 1841382066 |
---|---|
Provider Name | Mrs. Diane Fay Kahl |
First Address | Madison, WI 53704-1133 |
Second Address | Madison, WI 53704-1133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |