Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 01356 | IA |
NPI | 1457960841 |
---|---|
Provider Name | Mrs. Molly Catherine Mcgreal-Stence |
First Address | Des Moines, IA 50312-2413 |
Second Address | Johnston, IA 50131-3143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2020 |
Last Update Date | 30/07/2020 |