Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 0730000020 | VT |
NPI | 1023445244 |
---|---|
Provider Name | Mrs. Beth Louise Delano |
First Address | Worcester, VT 05682-9743 |
Second Address | Worcester, VT 05682-9743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2013 |
Last Update Date | 02/10/2013 |