Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 002344 | IA |
NPI | 1366618555 |
---|---|
Provider Name | Renae Ann Taylor |
First Address | Williamsburg, IA 52361-9346 |
Second Address | Corallville, IA 52241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2008 |
Last Update Date | 27/08/2014 |