Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 001860 | IA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 001860 | IA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 001860 | IA |
N | 225XP0200X | Occupational Therapist - Pediatrics | 001860 | IA |
NPI | 1962655571 |
---|---|
Provider Name | Mrs. Erica Cummings |
First Address | Wilton, IA 52778-9537 |
Second Address | Muscatine, IA 52761-5610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 28/10/2008 |