Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 32001592A | IN |
NPI | 1003071960 |
---|---|
Provider Name | Sarina Sherry |
First Address | South Bend, IN 46637-3834 |
Second Address | South Bend, IN 46637-3834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2008 |
Last Update Date | 21/07/2008 |