Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT19783 | FL |
NPI | 1164085940 |
---|---|
Provider Name | Mrs. Rebecca A Haller |
First Address | Pensacola, FL 32526-3279 |
Second Address | Pensacola, FL 32503-2732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2019 |
Last Update Date | 17/04/2019 |