Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | A165783688340 | FL |
NPI | 1255733168 |
---|---|
Provider Name | Mrs. Shafranna Camille Abraham |
First Address | Lake Worth, FL 33449-5468 |
Second Address | Lake Worth, FL 33449-5468 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2014 |
Last Update Date | 23/09/2014 |