Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 007948-1 | NY |
NPI | 1003206053 |
---|---|
Provider Name | Christine Bealer |
First Address | Montgomery, NY 12549-1037 |
Second Address | Poughkeepsie, NY 12601-3014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2015 |
Last Update Date | 29/01/2015 |