Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OC009363 | PA |
NPI | 1144298944 |
---|---|
Provider Name | Kelly O'connor |
First Address | Philadelphia, PA 19115-3411 |
Second Address | Horsham, PA 19044-2220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 08/07/2007 |