Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224Z00000X | Occupational Therapy Assistant | 0566 | NH |
N | 224Z00000X | Occupational Therapy Assistant | 073-0000184 | VT |
Y | 225200000X | Physical Therapy Assistant | 0925 | NH |
NPI | 1003093899 |
---|---|
Provider Name | Mrs. Terriellen Wood |
First Address | Hartland, VT 05048 |
Second Address | Lebanon, NH 03766 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2008 |
Last Update Date | 24/01/2008 |