Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 007163-1 | NY |
N | 225XF0002X | Feeding, Eating & Swallowing | ||
N | 225XH1200X | Occupational Therapist - Hand | 007163-1 | NY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 007163-1 | NY |
N | 225XP0200X | Occupational Therapist - Pediatrics | 007163-1 | NY |
NPI | 1255726014 |
---|---|
Provider Name | Ellen V Warren |
First Address | Warwick, NY 10990-1455 |
Second Address | Warwick, NY 10990-1455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 11/06/2019 |