Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 008241-1 | NY |
NPI | 1275751562 |
---|---|
Provider Name | Ms. Ann Marie Boland |
First Address | Cobleskill, NY 12043-5144 |
Second Address | Cobleskill, NY 12043-5144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 08/07/2007 |