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Individual
TONJA GILMORE
Active
Individual
TONJA GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L, SIPT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
NULL
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
NULL
225XH1300X
Human Factors Occupational Therapist
—
NULL
225XL0004X
Low Vision Occupational Therapist
—
NULL
225XP0019X
Physical Rehabilitation Occupational Therapist
—
NULL
225XP0200X
Pediatric Occupational Therapist
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029-9904-ET
CONTRACTOR'S EXCISE TAX LICENSE
SD
Enumeration date
08/24/2015
Last updated
08/24/2015
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