Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 009849-1 | NY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | E1555 | CO |
NPI | 1689862849 |
---|---|
Provider Name | Dr. Judy Nora Chiswell |
First Address | Williamsville, NY 14221-5835 |
Second Address | Williamsville, NY 14221-5835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2007 |
Last Update Date | 11/10/2007 |