Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | A02312 | MD |
NPI | 1013267889 |
---|---|
Provider Name | Jessica Conroy |
First Address | York, PA 17407-1014 |
Second Address | York, PA 17407-1014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2012 |
Last Update Date | 10/05/2021 |