Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 072.0081594 | VT |
NPI | 1023478013 |
---|---|
Provider Name | Tabitha Davis-Barron |
First Address | Greenwich, NY 12834-1233 |
Second Address | Greenwich, NY 12834-1233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2016 |
Last Update Date | 03/03/2016 |