Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 13155 | MA |
NPI | 1174198154 |
---|---|
Provider Name | Alice Hwang |
First Address | Salem, NH 03079-2529 |
Second Address | North Andover, MA 01845-1826 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2021 |
Last Update Date | 23/05/2021 |