Individual provider · NPI-1
Mae Engram
Developmental Therapist · Ruskin, FL
NPI number1104560648
StatusActive
Last updated in NPPESApr 21, 2022
Details
- NPI
- 1104560648
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Mae Engram
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 21, 2022
- Certification date
- Apr 21, 2022
- Last updated
- Apr 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Q00000X | Developmental Therapist | – | – | Yes |
Practice location
1708 Cabbage Key DrRuskin, FL 33570-7625
Phone 813-516-3880
Mailing address
1708 Cabbage Key DrRuskin, FL 33570-7625
Phone 813-516-3880
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