| NPI | 1801162763 |
|---|---|
| Former Name | ALYSSA RANDI WANAMAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 015291-1) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2012-03-26 |