Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 225XG0600X | Occupational Therapist - Gerontology | 8729355-4201 | UT |
NPI | 1952710410 |
---|---|
Provider Name | Sarah Maccombie |
First Address | Hillsborough, NJ 08844-3108 |
Second Address | Wilsonville, OR 97070-9697 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2014 |
Last Update Date | 10/11/2020 |