Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 0119006858 | VA |
Y | 225X00000X | Occupational Therapist | 17027 | CA |
NPI | 1003201070 |
---|---|
Provider Name | Kathryn Alexandra Motsko |
First Address | Johnson City, NY 13790-4508 |
Second Address | Owego, NY 13827-3433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 24/07/2019 |