Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201000615 | MI |
NPI | 1154750974 |
---|---|
Provider Name | Wendy V Early |
First Address | Ludington, MI 49431-1568 |
Second Address | Ludington, MI 49431-1568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2013 |
Last Update Date | 02/11/2013 |