Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 072-0000122 | VT |
NPI | 1174619647 |
---|---|
Provider Name | Ms. Lenore S Sopher |
First Address | Charlotte, VT 05445 |
Second Address | South Burlington, VT 05403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 13/03/2017 |