Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 2801 | MA |
NPI | 1013565431 |
---|---|
Provider Name | Amanda Jean Drozell |
First Address | Dennis, MA 02638-2441 |
Second Address | Harwich, MA 02645-1028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2019 |
Last Update Date | 28/08/2019 |