Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT2755 | FL |
NPI | 1124164413 |
---|---|
Provider Name | Susan Miller |
First Address | Lighthouse Point, FL 33064-8457 |
Second Address | Margate, FL 33063-5682 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 22/08/2007 |