Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 2476 | NH |
NPI | 1396118766 |
---|---|
Provider Name | Carmen Bugh |
First Address | Manchester, NH 03104-3455 |
Second Address | Nashua, NH 03060-4426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2015 |
Last Update Date | 07/11/2015 |