Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 13809 | NC |
NPI | 1720666084 |
---|---|
Provider Name | Mrs. Mirian Ruiz |
First Address | Asheville, NC 28704-8500 |
Second Address | Newport, NC 28570-8708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2021 |
Last Update Date | 30/03/2021 |