Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 6001 | MA |
NPI | 1013446160 |
---|---|
Provider Name | Carol Ann Dognazzi |
First Address | Newburyport, MA 01950-3071 |
Second Address | Newburyport, MA 01950-3071 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2017 |
Last Update Date | 11/06/2017 |