Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 020255 | NY |
NPI | 1003334764 |
---|---|
Provider Name | Danielle Achong |
First Address | Brooklyn, NY 11203-1450 |
Second Address | Brooklyn, NY 11230-5849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2017 |
Last Update Date | 01/09/2017 |