MEDICARE: MS. AUBREY PALMER LCAT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	221700000X	Art Therapist	001973	NY

General Provider Information

NPI Number	:	1386382646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AUBREY PALMER LCAT

Provider Business Mailing Address
First Line	:	20 HOLLY BLVD
Second Line	:
City	:	SCOTIA
State	:	NY
Zip	:	12302-3022
Country	:	US
Telephone Number	:	518-860-4619
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 HOLLY BLVD
Second Line	:
City	:	SCOTIA
State	:	NY
Zip	:	12302-3022
Country	:	US
Telephone Number	:	518-860-4619
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2022
Last Update Date	:	05/25/2022

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