Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0720000501 | VT |
NPI | 1124117619 |
---|---|
Provider Name | Jennifer Lori Palmer |
First Address | St George, VT 05495-8042 |
Second Address | South Burlington, VT 05403-4440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 10/03/2017 |