Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 10879-1 | NY |
NPI | 1003061847 |
---|---|
Provider Name | Leah Jenson |
First Address | New York, NY 10002-6169 |
Second Address | New York, NY 10001-3884 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2008 |
Last Update Date | 17/03/2014 |