Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 000987 | CT |
NPI | 1255333852 |
---|---|
Provider Name | Jerilyn A Nolan |
First Address | Danbury, CT 06810-6007 |
Second Address | Danbury, CT 06810-6007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 01/12/2008 |