Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 008520-1 | NY |
NPI | 1003205766 |
---|---|
Provider Name | Mrs. Laura Farber |
First Address | Buffalo, NY 14224-2648 |
Second Address | Buffalo, NY 14224-2648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2015 |
Last Update Date | 20/01/2015 |