Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 008341 | NY |
N | 224Z00000X | Occupational Therapy Assistant | 5145 | NC |
NPI | 1013221068 |
---|---|
Provider Name | Mrs. Debra Elizabeth Chase |
First Address | Castle Creek, NY 13744-1406 |
Second Address | Apalachin, NY 13732-1440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2010 |
Last Update Date | 09/10/2014 |