Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 4679 | CT |
NPI | 1073062402 |
---|---|
Provider Name | Jennifer Langrock |
First Address | Hamden, CT 06518-3209 |
Second Address | Branford, CT 06405-3036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2016 |
Last Update Date | 13/01/2022 |