Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 08363 | MD |
NPI | 1003387507 |
---|---|
Provider Name | Kathryn Garner |
First Address | Ellicott City, MD 21043-4910 |
Second Address | Glen Burnie, MD 21061-3291 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2018 |
Last Update Date | 09/12/2018 |