Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 4501 | TN |
NPI | 1083019434 |
---|---|
Provider Name | Stephanie Labrador Chin |
First Address | Memphis, TN 38117-5720 |
Second Address | Memphis, TN 38117-5720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2014 |
Last Update Date | 28/10/2014 |