Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 007100-1 | NY |
NPI | 1023386463 |
---|---|
Provider Name | Mrs. Tammy Lynn Rauber |
First Address | Olean, NY 14760-9333 |
Second Address | Olean, NY 14760-9333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2011 |
Last Update Date | 13/12/2011 |