Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 01031501 | NY |
NPI | 1003416249 |
---|---|
Provider Name | Briana Rae Ambesi |
First Address | Scotia, NY 12302-2906 |
Second Address | Guilderland, NY 12084-3505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2020 |
Last Update Date | 27/10/2020 |