Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | R2518 | KY |
NPI | 1033322110 |
---|---|
Provider Name | Victoria S Evans |
First Address | Georgetown, IN 47122 |
Second Address | Georgetown, IN 47122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |