Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 3053 | AL |
NPI | 1033436589 |
---|---|
Provider Name | Mrs. Janet Simon |
First Address | Hoover, AL 35216-4514 |
Second Address | Hoover, AL 35216-4514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2010 |
Last Update Date | 23/04/2010 |