Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC006912L | PA |
NPI | 1043542103 |
---|---|
Provider Name | Barbara Theresa Fisher |
First Address | Southampton, PA 18966-3546 |
Second Address | Southampton, PA 18966-3546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2010 |
Last Update Date | 31/01/2010 |