Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 102624 | MN |
N | 225X00000X | Occupational Therapist | 15811 | CA |
NPI | 1003276510 |
---|---|
Provider Name | Nichol R Vayder |
First Address | Salem, NH 03079-2839 |
Second Address | Salem, NH 03079-2839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2016 |
Last Update Date | 25/02/2016 |