Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 737 | OR |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 737 | OR |
N | 225XP0200X | Occupational Therapist - Pediatrics | 737 | OR |
NPI | 1376972497 |
---|---|
Provider Name | Ms. Marcia Dyk |
First Address | Turner, OR 97392-9607 |
Second Address | Turner, OR 97392-9607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2013 |
Last Update Date | 08/11/2013 |