Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC009535 | PA |
NPI | 1003821711 |
---|---|
Provider Name | Carrie Booher |
First Address | Coraopolis, PA 15108-3055 |
Second Address | Rochester, PA 15074-2165 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 08/07/2007 |