Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 004521 | CT |
NPI | 1003344912 |
---|---|
Provider Name | Sherry Ann Langrock |
First Address | Southbury, CT 06488-2322 |
Second Address | Danbury, CT 06810-6782 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2017 |
Last Update Date | 17/03/2018 |