Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 0082280-1 | NY |
NPI | 1376788018 |
---|---|
Provider Name | Mrs. Mara Dirado |
First Address | Johnson City, NY 13790-2107 |
Second Address | Johnson City, NY 13790 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2008 |
Last Update Date | 12/12/2008 |