Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 2020 | CT |
NPI | 1013567924 |
---|---|
Provider Name | Morgan Vallee |
First Address | Waterbury, CT 06708-1458 |
Second Address | Waterbury, CT 06708-1458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2019 |
Last Update Date | 13/09/2019 |