Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 2447 | MA |
NPI | 1023234697 |
---|---|
Provider Name | Diana Zwicker |
First Address | Danvers, MA 01923-2936 |
Second Address | Plymouth Meeting, PA 19462-1047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 08/07/2007 |