Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | TA090195 | NJ |
NPI | 1003934662 |
---|---|
Provider Name | James Begasse |
First Address | Vinton, VA 24179-1575 |
Second Address | Vinton, VA 24179-1575 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 08/07/2007 |