Individual
MARY PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 GRANT DR, RENO, NV 89509-5474
(775) 829-4700
Mailing address
3700 GRANT DR, RENO, NV 89509-5474
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OT--2503
NV
225X00000X
Occupational Therapist
Primary
OT2503
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149193694
CAQH
NV
Enumeration date
08/19/2020
Last updated
12/11/2020
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