Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CX0006X | Orientation and Mobility Training Provider | ||
Y | 225X00000X | Occupational Therapist | 011763 | NY |
NPI | 1164639993 |
---|---|
Provider Name | Ms. Eileen Kathryn Dashnaw |
First Address | Salem, NY 12865-1914 |
Second Address | Salem, NY 12865-1914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 03/08/2010 |