Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 008750 | NY |
NPI | 1023534583 |
---|---|
Provider Name | Jennifer Lynn O'connor |
First Address | Hamburg, NY 14075-4816 |
Second Address | Buffalo, NY 14214-2152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2017 |
Last Update Date | 16/08/2017 |