Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 11783 | MA |
NPI | 1003281734 |
---|---|
Provider Name | Kristen Fisher |
First Address | Salem, NH 03079 |
Second Address | Salem, NH 03079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2015 |
Last Update Date | 07/12/2015 |