Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 072.0000089 | VT |
NPI | 1225374184 |
---|---|
Provider Name | Mrs. Wendy Crowe Watson |
First Address | Montpelier, VT 05602-8699 |
Second Address | Barre, VT 05641-5360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2012 |
Last Update Date | 21/12/2012 |