Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT2944 | MS |
NPI | 1003223595 |
---|---|
Provider Name | Mrs. Katie Hunt |
First Address | Hernando, MS 38632-2245 |
Second Address | Hernando, MS 38632-2245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2014 |
Last Update Date | 16/07/2014 |