Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003363136 |
---|---|
Provider Name | Kelly Rodden |
First Address | West Chester, PA 19380-4278 |
Second Address | West Chester, PA 19380-4278 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2016 |
Last Update Date | 07/09/2016 |