Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1306869151 |
---|---|
Provider Name | Mrs. Dionne Delorie Espeut-Mitchell |
First Address | Boston, MA 02130 |
Second Address | Boston, MA 02130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 08/07/2007 |