Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 0825 | NH |
NPI | 1013682723 |
---|---|
Provider Name | Ms. Laura Thomsen Jimenez |
First Address | Nashua, NH 03060-4849 |
Second Address | Bedford, NH 03110-6426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2021 |
Last Update Date | 13/08/2021 |