Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 3230 | AL |
NPI | 1346688744 |
---|---|
Provider Name | Terri Pope |
First Address | Daphne, AL 36526-8304 |
Second Address | Mobile, AL 36607-1822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2013 |
Last Update Date | 06/06/2013 |