Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 1060 | SD |
NPI | 1063021756 |
---|---|
Provider Name | Mrs. Sarah Rae Viola |
First Address | Aberdeen, SD 57401-6863 |
Second Address | Aberdeen, SD 57401-6863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2020 |
Last Update Date | 28/07/2020 |