Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 335495-4201 | UT |
NPI | 1689823338 |
---|---|
Provider Name | Richard Aaron Winn |
First Address | Salt Lake City, UT 84130-0180 |
Second Address | Provo, UT 84604-3380 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2008 |
Last Update Date | 17/09/2008 |