Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 06977 | MD |
N | 225XH1200X | Occupational Therapist - Hand | 06977 | MD |
NPI | 1033468210 |
---|---|
Provider Name | Ashley N Landis |
First Address | Frederick, MD 21702-4348 |
Second Address | Frederick, MD 21702-4348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2012 |
Last Update Date | 17/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G00315 | (02) |