Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0119000559 | VA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 115866 | TX |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1313 | HI |
NPI | 1255749073 |
---|---|
Provider Name | Ms. Patricia Cooper |
First Address | North Chesterfield, VA 23237-4733 |
Second Address | Omaha, NE 68154-5260 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2014 |
Last Update Date | 24/07/2014 |