Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 015478-1 | NY |
NPI | 1023321049 |
---|---|
Provider Name | Mrs. Carol Brown-Wassinger |
First Address | College Point, NY 11356-1802 |
Second Address | College Point, NY 11356-1802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2010 |
Last Update Date | 19/07/2010 |