Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP000397L | PA |
NPI | 1023346251 |
---|---|
Provider Name | Joanne Kolb |
First Address | Coopersburg, PA 18036-3622 |
Second Address | Plymouth Meeting, PA 19462-1047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2009 |
Last Update Date | 30/11/2009 |