Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 14629 | FL |
NPI | 1598057101 |
---|---|
Provider Name | Mrs. La'shone Renee Wilson-Morise |
First Address | Seguin, TX 78155-1857 |
Second Address | Seguin, TX 78155-1857 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2011 |
Last Update Date | 15/05/2011 |