Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OC016356 | PA |
NPI | 1851913297 |
---|---|
Provider Name | Dr. Brooke Dexheimer |
First Address | State College, PA 16801-6847 |
Second Address | State College, PA 16801-6847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2020 |
Last Update Date | 07/05/2020 |