Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant |
NPI | 1013519933 |
---|---|
Provider Name | Mrs. Precious Joy Thole-Judovsky |
First Address | Fargo, ND 58102 |
Second Address | Fargo, ND 58102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2020 |
Last Update Date | 16/11/2020 |