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General NPI Number Information
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NPI Number | 1972242139
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Entity Type | Organization
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Legal Business Name | GROW YOUR OWN WAY OCCUPATIONAL THERAPY
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Dates
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Enumeration Date | 06/03/2022
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 150 W BAYARD ST
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City | SENECA FALLS
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State | NY
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Zip | 13148-1714
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Country | US
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Telephone | 518-810-1771
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Fax |
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Provider Business Mailing Address
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Address Line | 150 W BAYARD ST
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City | SENECA FALLS
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State | NY
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Zip | 13148-1714
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Country | US
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Telephone | 518-810-1771
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Fax |
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | DARCY HERRON
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Credential |
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Telephone | 518-810-1771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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