Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 5201009726 | MI |
NPI | 1134386634 |
---|---|
Provider Name | Rebecca Hawkins |
First Address | Battle Creek, MI 49015-9389 |
Second Address | Battle Creek, MI 49015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 13/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5201009726 | OT (01) | MI |