Individual
MRS. NANCY Y HER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ORT/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104579
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104579
MN STATE OCCUPATIONAL THERAPY
MN
Enumeration date
06/03/2021
Last updated
06/03/2021
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