Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner | OC006456 L | PA |
N | 225X00000X | Occupational Therapist | OC006456 L | PA |
N | 2251E1200X | Ergonomics | OC006456 L | PA |
N | 225XE1200X | Ergonomics | OC006456 L | PA |
N | 225XH1200X | Occupational Therapist - Hand | OC006456 L | PA |
N | 225XP0200X | Occupational Therapist - Pediatrics | OC006456 L | PA |
NPI | 1316921422 |
---|---|
Provider Name | Heidi Gowden |
First Address | Dickson City, PA 18519-1677 |
Second Address | Dickson City, PA 18519-1677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018635910003 | (05) | PA |
1563663 | HIGHMARK (01) | PA |
163621 | MEDPLUS (01) | PA |
2637127 | AETNA HMO (01) | PA |
7722289 | AETNA PPO (01) | PA |
819207 | FIRST PRIORITY/BC/BS (01) | PA |
9358705 | PHCS (01) | PA |