Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 00848 | RI |
NPI | 1114198710 |
---|---|
Provider Name | Mrs. Michelle Tedesco Choquette |
First Address | Providence, RI 02901-1119 |
Second Address | East Providence, RI 02914-5375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2008 |
Last Update Date | 17/12/2019 |