Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 006037-1 | NY |
NPI | 1013296516 |
---|---|
Provider Name | Ms. Denise Deborah Rickard |
First Address | Schenectady, NY 12302-3321 |
Second Address | Schenectady, NY 12302-3321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2011 |
Last Update Date | 15/08/2011 |