Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 7601 | FL |
NPI | 1063938579 |
---|---|
Provider Name | Mrs. Rhonda L Heflin |
First Address | Jay, FL 32565-1219 |
Second Address | Jay, FL 32565-1219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2017 |
Last Update Date | 16/08/2017 |