Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 05540 | MD |
NPI | 1013351576 |
---|---|
Provider Name | Katherine Miller |
First Address | Ellicott City, MD 21042-7612 |
Second Address | Ellicott City, MD 21042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2013 |
Last Update Date | 07/01/2019 |