Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA11044 | FL |
NPI | 1013273408 |
---|---|
Provider Name | Ms. Brittany Mulkey |
First Address | Lake Mary, FL 32746-3787 |
Second Address | Winter Park, FL 32792-5313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2012 |
Last Update Date | 10/04/2012 |