Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 8369 | NC |
Y | 225XG0600X | Occupational Therapist - Gerontology | OT.4115 OT | SC |
NPI | 1245675008 |
---|---|
Provider Name | Naama Rosenheck |
First Address | Myrtle Beach, SC 29579-8275 |
Second Address | Myrtle Beach, SC 29579-8275 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2013 |
Last Update Date | 13/06/2013 |