Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 002814 | CT |
NPI | 1740516715 |
---|---|
Provider Name | Mrs. Abigail Renee Wood |
First Address | West Hartford, CT 06119-6320 |
Second Address | West Hartford, CT 06119-6320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2009 |
Last Update Date | 27/10/2009 |