Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC004534L | PA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC004534L | PA |
NPI | 1104103845 |
---|---|
Provider Name | Julie Walter |
First Address | Mckeesport, PA 15132-2422 |
Second Address | Mckeesport, PA 15132-2422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2011 |
Last Update Date | 05/04/2021 |