Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 20629 | FL |
NPI | 1003440660 |
---|---|
Provider Name | Thy Cam Huynh |
First Address | Gainesville, FL 32610 |
Second Address | Gainesville, FL 32610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2020 |
Last Update Date | 04/05/2020 |