Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT3951 | FL |
N | 225XH1200X | Occupational Therapist - Hand | OT3951 | FL |
NPI | 1164051892 |
---|---|
Provider Name | Mrs. Maria Antonia Dickstein |
First Address | Pembroke Pines, FL 33028-1006 |
Second Address | Pembroke Pines, FL 33028-1006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2020 |
Last Update Date | 04/04/2020 |