Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 3116 | NH |
N | 225XP0200X | Occupational Therapist - Pediatrics | 3116 | NH |
NPI | 1003499179 |
---|---|
Provider Name | Mia Briana Dimeglio |
First Address | Keene, NH 03431-2420 |
Second Address | Greenfield, NH 03047-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2021 |
Last Update Date | 28/07/2021 |