Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP006260 | PA |
NPI | 1013294081 |
---|---|
Provider Name | Donna J Gray |
First Address | Birdsboro, PA 19508-8299 |
Second Address | Allentown, PA 18103-3880 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2011 |
Last Update Date | 04/11/2011 |