Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT005000 | GA |
Y | 225X00000X | Occupational Therapist | OT17836 | FL |
NPI | 1003363573 |
---|---|
Provider Name | Mrs. Meagin Knight Stephenson |
First Address | Winter Park, FL 32789-1316 |
Second Address | Winter Park, FL 32789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2016 |
Last Update Date | 01/09/2016 |