Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 002707-1 | NY |
NPI | 1033261854 |
---|---|
Provider Name | Mrs. Rhonda Marie Winner-Dodzweit |
First Address | Lisle, NY 13797-1312 |
Second Address | Johnson City, NY 13790-2106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 08/07/2007 |