Individual
MRS. AUTUMN R WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L, CLT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119004134
VA
225X00000X
Occupational Therapist
Primary
05586
MD
225X00000X
Occupational Therapist
OC009784
PA
Other
Enumeration date
07/31/2006
Last updated
09/24/2008
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