Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 573 | CT |
NPI | 1023208790 |
---|---|
Provider Name | Kathy Reiff |
First Address | Waterbury, CT 06708-3104 |
Second Address | Waterbury, CT 06708-3104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 30/07/2007 |