Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003945551 |
---|---|
Provider Name | Kelly R Hiltz |
First Address | Easton, PA 18040-7958 |
Second Address | Frederick, MD 21703-7039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 09/07/2007 |