Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224Z00000X | Occupational Therapy Assistant | ||
N | 225X00000X | Occupational Therapist | 1289 | NC |
Y | 225XH1200X | Occupational Therapist - Hand | 1289 | NC |
NPI | 1053412817 |
---|---|
Provider Name | Ms. Jennifer Clinton Vernon |
First Address | Asheville, NC 28803-3152 |
Second Address | Weaverville, NC 28787-9492 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 04/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7302005 | (05) | NC |