Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 007178 | NY |
N | 225XG0600X | Occupational Therapist - Gerontology | 007178 | NY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 007178 | NY |
N | 225XP0200X | Occupational Therapist - Pediatrics | 007178 | NY |
NPI | 1932344942 |
---|---|
Provider Name | Celina Colette Roberts |
First Address | West Hempstead, NY 11552-2830 |
Second Address | West Hempstead, NY 11552-2830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2008 |
Last Update Date | 04/12/2008 |