Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 5533 | NC |
NPI | 1295261832 |
---|---|
Provider Name | Tinamarie Gnolfo |
First Address | Raleigh, NC 27612-6352 |
Second Address | Raleigh, NC 27612-6352 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2017 |
Last Update Date | 02/05/2017 |