Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 015888-1 | NY |
NPI | 1194009449 |
---|---|
Provider Name | Mrs. Dori Lynn Mcgowan |
First Address | Binghamton, NY 13905-4503 |
Second Address | Binghamton, NY 13903-1651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 05/10/2011 |