Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA000224 | RI |
NPI | 1023392073 |
---|---|
Provider Name | Thomas Lima |
First Address | Greene, RI 02827-2206 |
Second Address | Greene, RI 02827-2206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2011 |
Last Update Date | 07/10/2011 |