Individual
ANOUSONE INTHIRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTP-OTA-LIC-10547
MT
224Z00000X
Occupational Therapy Assistant
—
—
225700000X
Massage Therapist
—
—
Other
Enumeration date
12/31/2015
Last updated
06/08/2025
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