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Individual

TONJA GILMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, OTR/L, SIPT

Contact information

Practice address
30972 434TH AVE, YANKTON, SD 57078-6700
(802) 535-1557
Mailing address
30972 434TH AVE, YANKTON, SD 57078-6700
(802) 535-1557

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
225XH1300X
Human Factors Occupational Therapist
225XL0004X
Low Vision Occupational Therapist
225XP0019X
Physical Rehabilitation Occupational Therapist
225XP0200X
Pediatric Occupational Therapist

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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