Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner | 00120270 | NY |
NPI | 1396392205 |
---|---|
Provider Name | Ms. Lisa M Gentzler |
First Address | Niagara Falls, NY 14303-1908 |
Second Address | Niagara Falls, NY 14303-1908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2019 |
Last Update Date | 26/08/2019 |