Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 009494-1 | NY |
NPI | 1023158599 |
---|---|
Provider Name | Jennifer Lynne Walsh |
First Address | West Hempstead, NY 11552-3016 |
Second Address | West Hempstead, NY 11552-3016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |