Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 3560 | NM |
NPI | 1023561354 |
---|---|
Provider Name | Sarah Herrington |
First Address | Farmington, NM 87401-9632 |
Second Address | Farmington, NM 87401-9632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2016 |
Last Update Date | 03/08/2016 |