Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 057.002890 | IL |
NPI | 1023478997 |
---|---|
Provider Name | Nancy Linstra |
First Address | Orlando, FL 32817-1481 |
Second Address | Orlando, FL 32817-1481 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2016 |
Last Update Date | 04/03/2016 |