Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 05554 | MD |
NPI | 1447653621 |
---|---|
Provider Name | Elizabeth Flanigan |
First Address | Baltimore, MD 21234-5016 |
Second Address | Baltimore, MD 21234-5016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2014 |
Last Update Date | 02/10/2014 |