Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | U1 0000880 | DE |
NPI | 1184605107 |
---|---|
Provider Name | Eileen Scanlon |
First Address | Bolingbrook, IL 60440-4909 |
Second Address | Dover, DE 19904-5773 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 04/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000041626 | (05) | DE |