Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 8477 | MA |
NPI | 1063714152 |
---|---|
Provider Name | Mrs. Katherine Schaefer Cooney |
First Address | Marion, MA 02738-5100 |
Second Address | Forestdale, MA 02644-1140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2010 |
Last Update Date | 23/11/2010 |