Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP-000677-L | PA |
NPI | 1013063858 |
---|---|
Provider Name | Bonnie Langan |
First Address | Easton, PA 18040-7958 |
Second Address | Boyertown, PA 19512-1041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 08/07/2007 |