Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 001430 | CT |
NPI | 1013403591 |
---|---|
Provider Name | Venice M Robinson |
First Address | New Haven, CT 06513-4001 |
Second Address | New Haven, CT 06513-4001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2018 |
Last Update Date | 08/07/2018 |