Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OC011083 | PA |
NPI | 1639306350 |
---|---|
Provider Name | Jennifer Marie Thatcher |
First Address | Easton, PA 18045-2513 |
Second Address | Allentown, PA 18109-2422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2009 |
Last Update Date | 21/12/2011 |