Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 1951 | NE |
Y | 225X00000X | Occupational Therapist | 2015033916 | MO |
NPI | 1003349010 |
---|---|
Provider Name | Natasha Elizabeth Maune |
First Address | Washington, MO 63090-4237 |
Second Address | Washington, MO 63090-4237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2017 |
Last Update Date | 06/04/2017 |