Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA 8209 | FL |
NPI | 1013114115 |
---|---|
Provider Name | Vilma H. Dennis |
First Address | Easton, PA 18040-7958 |
Second Address | Gainesville, FL 32607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 08/07/2007 |