Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 072.0061421 | VT |
NPI | 1033486154 |
---|---|
Provider Name | Desiree Ann Rice |
First Address | Newport, VT 05855-4953 |
Second Address | Newport, VT 05855-4953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2011 |
Last Update Date | 17/11/2011 |