Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 767 | NH |
NPI | 1023341302 |
---|---|
Provider Name | Martha Capuco |
First Address | Concord, NH 03301-3478 |
Second Address | Concord, NH 03301-3478 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2009 |
Last Update Date | 17/09/2009 |