Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT2512 | FL |
NPI | 1023294881 |
---|---|
Provider Name | Mrs. Julie Thompson |
First Address | Ormond Beach, FL 32174-7958 |
Second Address | Ormond Beach, FL 32174-7958 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2008 |
Last Update Date | 30/07/2017 |