Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 006786-01 | NY |
NPI | 1013681568 |
---|---|
Provider Name | Mrs. Wendy Louise Bonter |
First Address | Hilton, NY 14468-9135 |
Second Address | Rochester, NY 14621-3065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2021 |
Last Update Date | 06/08/2021 |