Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1064 | PR |
N | 2251E1200X | Ergonomics | 1064 | PR |
N | 225XE1200X | Ergonomics | 1064 | PR |
N | 225XH1200X | Occupational Therapist - Hand | 1064 | PR |
N | 2251H1300X | Human Factors | 1064 | PR |
N | 225XH1300X | Human Factors | 1064 | PR |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 1064 | PR |
N | 225XP0200X | Occupational Therapist - Pediatrics | 1064 | PR |
NPI | 1154380814 |
---|---|
Provider Name | Mrs. Idania Roldan |
First Address | Ceiba, PR 00924 |
Second Address | Ceiba, PR 00924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 06/02/2008 |