Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1215567821 |
---|---|
Provider Name | Ms. Courtney Jessica Pickney |
First Address | Montgomery, AL 36116-8800 |
Second Address | Montgomery, AL 36104-4610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2020 |
Last Update Date | 22/01/2020 |