Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT15779 | FL |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT005684 | GA |
NPI | 1023454964 |
---|---|
Provider Name | Kathryn Hartman Bishop |
First Address | Jacksonville, FL 32223-8618 |
Second Address | Jacksonville, FL 32223-8618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 17/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014829900 | (05) | FL |