Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 5202007142 | MI |
NPI | 1013486190 |
---|---|
Provider Name | Ms. Lynn Marie Kobes |
First Address | Holland, MI 49423-9744 |
Second Address | Holland, MI 49423-5205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2018 |
Last Update Date | 18/11/2018 |