Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA9462 | FL |
NPI | 1023389947 |
---|---|
Provider Name | Ms. Linda L D'agostino |
First Address | Boynton Beach, FL 33436-1560 |
Second Address | Boynton Beach, FL 33436-1560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2012 |
Last Update Date | 24/01/2012 |