Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OC010319 | PA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC010319 | PA |
NPI | 1043541600 |
---|---|
Provider Name | Jessica Levy |
First Address | Lititz, PA 17543-7675 |
Second Address | Lititz, PA 17543-7675 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2010 |
Last Update Date | 21/01/2010 |