Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 06028 | MD |
NPI | 1598889396 |
---|---|
Provider Name | Karen Elaine Martz |
First Address | Severn, MD 21144-2808 |
Second Address | Millersville, MD 21108-2111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 09/06/2009 |