Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC018175 | PA |
NPI | 1235880154 |
---|---|
Provider Name | Dana Lynn Richard |
First Address | West Chester, PA 19382-8507 |
Second Address | West Chester, PA 19382-8507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2022 |
Last Update Date | 12/01/2022 |