Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | U1-0000924 | DE |
NPI | 1316367428 |
---|---|
Provider Name | Ms. Evyline Chioma |
First Address | Newark, DELAWARE 19702 |
Second Address | Newark, DELAWARE 19702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2014 |
Last Update Date | 16/04/2014 |