Individual
MRS. VIRGINIA HELENE MIKA
Active
Individual
MRS. VIRGINIA HELENE MIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR532
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119287600
—
WY
01
—
312278
BLUE CROSS BLUE SHIELD
WY
Enumeration date
08/14/2006
Last updated
02/03/2009
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