Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 6113 | FL |
NPI | 1083910061 |
---|---|
Provider Name | Mrs. Josee Scully |
First Address | Clearwater, FL 33756-3397 |
Second Address | Clearwater, FL 33756-3397 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2011 |
Last Update Date | 08/02/2011 |