Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0221121 | NY |
NPI | 1003315441 |
---|---|
Provider Name | Caitlyn Lemery |
First Address | Ithaca, NY 14850-5639 |
Second Address | Ithaca, NY 14850-5639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2018 |
Last Update Date | 11/02/2018 |