Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 3039 | NH |
NPI | 1003418377 |
---|---|
Provider Name | Sara Marie Roy |
First Address | Nashua, NH 03062-1631 |
Second Address | Salem, NH 03079-2886 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2020 |
Last Update Date | 12/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3039 | ALLIED HEALTH PROFESSIONS (01) | NH |