Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0017411 | NY |
NPI | 1003941063 |
---|---|
Provider Name | Mrs. Deborah W Shaffer |
First Address | Gaylordsville, CT 06755-1002 |
Second Address | Poughkeepsie, NY 12603-6519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 08/07/2007 |