Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA.0000477 | CO |
NPI | 1023401833 |
---|---|
Provider Name | Ms. Conny Seay |
First Address | Cedaredge, CO 81413-8122 |
Second Address | Eckert, CO 81418-5213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2015 |
Last Update Date | 18/03/2015 |