Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | NY | |
Y | 225XP0200X | Occupational Therapist - Pediatrics | NY |
NPI | 1679948681 |
---|---|
Provider Name | Nakisha L Henry |
First Address | Bronx, NY 10475-2955 |
Second Address | Bronx, NY 10475-2955 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2015 |
Last Update Date | 02/12/2015 |