Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 5058 | AZ |
NPI | 1629597141 |
---|---|
Provider Name | Robin Hamilton |
First Address | Scottsdale, AZ 85255 |
Second Address | Scottsdale, AZ 85255-4566 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2017 |
Last Update Date | 15/09/2017 |