Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 009876-1 | NY |
NPI | 1023679453 |
---|---|
Provider Name | Ann M Sutton |
First Address | Albany, NY 12208-1708 |
Second Address | Albany, NY 12208-1708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2019 |
Last Update Date | 26/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1032 | (05) | NY |