Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 006890-1 | NY |
N | 224Z00000X | Occupational Therapy Assistant | OP006681 | PA |
NPI | 1013158740 |
---|---|
Provider Name | Rebecca Smaczniak |
First Address | Cheektowaga, NY 14227-3022 |
Second Address | Cheektowaga, NY 14227-3022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2009 |
Last Update Date | 09/03/2009 |