Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP006032 | PA |
NPI | 1003023136 |
---|---|
Provider Name | Alison Jordan |
First Address | Bethlehem, PA 18017-8714 |
Second Address | Nazareth, PA 18064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 08/07/2007 |