Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 002569 | CT |
N | 225XH1200X | Occupational Therapist - Hand |
NPI | 1245337831 |
---|---|
Provider Name | Melissa L. Jurgen |
First Address | Hamden, CT 06518-3209 |
Second Address | Hamden, CT 06518-3248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2006 |
Last Update Date | 09/12/2020 |