Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 016388-1 | NY |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 016388-1 | NY |
NPI | 1346689239 |
---|---|
Provider Name | Brianna Schafer |
First Address | Liverpool, NY 13088-4729 |
Second Address | Syracuse, NY 13210-2716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2013 |
Last Update Date | 24/06/2013 |