Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | 005675-1 | NY |
Y | 225XH1200X | Occupational Therapist - Hand | 9136 | MA |
NPI | 1124120456 |
---|---|
Provider Name | Miss Erin Colleen Fleig |
First Address | Great Barrington, MA 01230-1773 |
Second Address | Great Barrington, MA 01230-1773 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 27/01/2010 |