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General NPI Number Information
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NPI Number | 1073046942
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Entity Type | Individual
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Provider Name | ALLISSA YOUNAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 01/03/2021
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Provider Practice Location Address
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Address Line | 204D MAIN ST
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City | EPPING
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State | NH
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Zip | 03042-2430
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Country | US
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Telephone | 845-492-6928
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Fax |
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Provider Business Mailing Address
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Address Line | 204D MAIN ST
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City | EPPING
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State | NH
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Zip | 03042-2430
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Country | US
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Telephone | 845-492-6928
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2931
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 12271
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License Number State | MA
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