Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1023378452 |
---|---|
Provider Name | Taneal Behm |
First Address | Windsor, CO 80550-6102 |
Second Address | Windsor, CO 80550-6102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2012 |
Last Update Date | 18/05/2012 |