Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 007384 | NY |
NPI | 1003120940 |
---|---|
Provider Name | Nickie Hamer |
First Address | Batavia, NY 14020-1306 |
Second Address | Batavia, NY 14020-3246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2010 |
Last Update Date | 03/08/2010 |