Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 1520 | MA |
NPI | 1013283944 |
---|---|
Provider Name | Mrs. Amy A. Santos |
First Address | Pittsfield, MA 01201-4429 |
Second Address | Pittsfield, MA 01201-4429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2012 |
Last Update Date | 26/03/2012 |