Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 07221 | MD |
NPI | 1003244617 |
---|---|
Provider Name | Andrea Sobczak |
First Address | Baltimore, MD 21224-4716 |
Second Address | Baltimore, MD 21218-3934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2013 |
Last Update Date | 16/10/2013 |