Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | C1356 | WV |
NPI | 1013140433 |
---|---|
Provider Name | Ms. Kiley Michelle Price |
First Address | Oak Hill, WV 25901-0686 |
Second Address | Ansted, WV 25812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2009 |
Last Update Date | 02/09/2009 |