Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 003578-1 | NY |
NPI | 1033363593 |
---|---|
Provider Name | Miss Deborah Ann Yonkers |
First Address | Oswego, NY 13126-6494 |
Second Address | Oswego, NY 13126-2045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2008 |
Last Update Date | 11/11/2008 |