Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 072.0000010 | VT |
NPI | 1053779983 |
---|---|
Provider Name | Mrs. Barbara Ebenstein |
First Address | Richmond, VT 05477-9423 |
Second Address | Richmond, VT 05477-9423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2016 |
Last Update Date | 06/02/2016 |