Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 63 017825 | NY |
NPI | 1114268596 |
---|---|
Provider Name | Mrs. Karen Elizabeth Coulter |
First Address | Elmira, NY 14905-2219 |
Second Address | Elmira, NY 14901-3223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2013 |
Last Update Date | 08/03/2013 |