Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 009623 | NY |
NPI | 1023517190 |
---|---|
Provider Name | Ms. Alyssa Morra |
First Address | Bronx, NY 10465-3104 |
Second Address | Woodside, NY 11377-5054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2018 |
Last Update Date | 05/02/2018 |