Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 3011 | NH |
NPI | 1073137022 |
---|---|
Provider Name | Annelise Fox |
First Address | Epsom, NH 03234 |
Second Address | Laconia, NH 03246-3600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2020 |
Last Update Date | 05/06/2020 |