Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 000284 | CT |
NPI | 1114261724 |
---|---|
Provider Name | Mrs. Susan Saul Lin |
First Address | Wethersfield, CT 06109-3996 |
Second Address | Wethersfield, CT 06109-3996 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2012 |
Last Update Date | 20/11/2012 |