Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 001089 | CT |
Y | 225XH1200X | Occupational Therapist - Hand | 001089 | CT |
NPI | 1003872730 |
---|---|
Provider Name | Terry L Watson |
First Address | Woodbridge, CT 06525-2256 |
Second Address | Southington, CT 06489-2537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 15/09/2016 |