Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT 11012 | FL |
NPI | 1003247909 |
---|---|
Provider Name | Ms. Jane Ellen Sendrovich |
First Address | Vero Beach, FL 32967-7583 |
Second Address | Vero Beach, FL 32967-7583 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2013 |
Last Update Date | 03/12/2013 |