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Individual
MRS. THERESA M MORAN
Active
Individual
MRS. THERESA M MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
005691-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005691-1
NYS EDUCATION LISCENSURE NUMBER
NY
Enumeration date
09/15/2010
Last updated
09/15/2010
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