Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 000938-1 | NY |
NPI | 1013314871 |
---|---|
Provider Name | Elaine Cleveland |
First Address | Buffalo, NY 14221-7220 |
Second Address | Buffalo, NY 14221-7220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2014 |
Last Update Date | 21/11/2014 |