Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 01069401 | OR |
NPI | 1003033622 |
---|---|
Provider Name | Ms. Jennifer R Dean |
First Address | Bayard, NM 88023-0165 |
Second Address | Eugene, OR 97405-1116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 08/07/2007 |