Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 9972 | MA |
NPI | 1003232679 |
---|---|
Provider Name | Sarah Clement |
First Address | Nashua, NH 03060-4073 |
Second Address | Haverhill, MA 01830-2217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2014 |
Last Update Date | 06/03/2014 |