Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 056.011904 | IL |
NPI | 1003348285 |
---|---|
Provider Name | Rachel Giese |
First Address | Franklin, WI 53132-2264 |
Second Address | Wheeling, IL 60090-2980 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2017 |
Last Update Date | 28/03/2017 |