Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 6157 | FL |
NPI | 1164546909 |
---|---|
Provider Name | Mrs. Lynn Ann Agnew |
First Address | Tampa, FL 33618-1168 |
Second Address | Tampa, FL 33614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |