Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC012921 | PA |
N | 225XG0600X | Occupational Therapist - Gerontology | OC012921 | PA |
NPI | 1073943056 |
---|---|
Provider Name | Ashley Dinko |
First Address | White Haven, PA 18661-3039 |
Second Address | Frackville, PA 17931-2018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2013 |
Last Update Date | 12/11/2013 |