Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 003489 | CT |
NPI | 1043600513 |
---|---|
Provider Name | Amy Philosoph |
First Address | Fairfield, CT 06825-2541 |
Second Address | Fairfield, CT 06825-2541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2015 |
Last Update Date | 02/05/2021 |