Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 057000493 | IL |
N | 2251E1200X | Ergonomics | 057000493 | IL |
N | 225XE1200X | Ergonomics | 057000493 | IL |
NPI | 1891074530 |
---|---|
Provider Name | Mrs. Donna Lynn Muehlbacher |
First Address | Mokena, IL 60448-9572 |
Second Address | Mokena, IL 60448-9572 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2011 |
Last Update Date | 11/08/2011 |