Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 03232 | MD |
NPI | 1073784856 |
---|---|
Provider Name | Holly Lynn Stevens |
First Address | Baltimore, MD 21213-3939 |
Second Address | Baltimore, MD 21205-1832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2008 |
Last Update Date | 19/03/2008 |