Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC016494 | PA |
NPI | 1356967889 |
---|---|
Provider Name | Bridget A Breen |
First Address | Lansdale, PA 19446-4743 |
Second Address | Lakewood, NJ 08701-5288 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2020 |
Last Update Date | 25/06/2020 |