Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 06092 | MD |
NPI | 1396107868 |
---|---|
Provider Name | Amanda Littleton |
First Address | Parkville, MD 21234-3014 |
Second Address | Towson, MD 21286 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2016 |
Last Update Date | 24/03/2016 |