Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 006389-1 | NY |
NPI | 1003963653 |
---|---|
Provider Name | Janice Ann Mccutchan |
First Address | Fairport, NY 14450-1919 |
Second Address | Fairport, NY 14450-1327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 06/10/2011 |