Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 008884 | NY |
NPI | 1003274044 |
---|---|
Provider Name | Kenna Boyce |
First Address | Alliance, OH 44601-9641 |
Second Address | Oswego, NY 13126-2045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2016 |
Last Update Date | 05/02/2016 |