Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant |
NPI | 1013208065 |
---|---|
Provider Name | Tesheena Millsaps |
First Address | Wilton, CT 06897-4429 |
Second Address | Wilton, CT 06897-4429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2011 |
Last Update Date | 26/04/2011 |