Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 003901-1 | NY |
NPI | 1003064759 |
---|---|
Provider Name | Robin Yaeger |
First Address | Lockport, NY 14094-5842 |
Second Address | Lockport, NY 14094-9640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2008 |
Last Update Date | 07/09/2008 |