Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 06208 | MD |
N | 225XH1200X | Occupational Therapist - Hand | 06208 | MD |
NPI | 1083006076 |
---|---|
Provider Name | Jennifer Rhodes Nicholas |
First Address | Lutherville, MD 21093 |
Second Address | Lutherville, MD 21093 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2015 |
Last Update Date | 09/09/2020 |