Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | ||
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 225X00000X |
NPI | 1841768603 |
---|---|
Provider Name | Mrs. Linda Anne Brown |
First Address | Elsie, MI 48831-9255 |
Second Address | Elsie, MI 48831-9255 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2018 |
Last Update Date | 08/11/2018 |