Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 004512 | CT |
NPI | 1043560923 |
---|---|
Provider Name | Sarah Tommaso |
First Address | Fairfield, CT 06824-6038 |
Second Address | Wallingford, CT 06492-2360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2012 |
Last Update Date | 18/09/2012 |