Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 0091321 | NY |
NPI | 1013497015 |
---|---|
Provider Name | Lunise Joacin |
First Address | Spring Valley, NY 10977-5333 |
Second Address | Hartsdale, NY 10530-1952 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2018 |
Last Update Date | 19/08/2018 |