Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 398172 | OR |
NPI | 1003070251 |
---|---|
Provider Name | Ms. Patricia Van Scoy |
First Address | Medford, OR 97504-6505 |
Second Address | Medford, OR 97504-6505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 16/07/2008 |