Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 16339 | FL |
NPI | 1326437807 |
---|---|
Provider Name | Amber Avery |
First Address | New Boston, NH 03070-3726 |
Second Address | Lynn, MA 01902-3068 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2015 |
Last Update Date | 13/02/2019 |