Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 05900 | MD |
N | 225XL0004X | Low Vision | 05900 | MD |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 05900 | MD |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 05900 | MD |
NPI | 1013339951 |
---|---|
Provider Name | Kristen Lindeman Shifflett |
First Address | Baltimore, MD 21287 |
Second Address | Baltimore, MD 21287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2014 |
Last Update Date | 08/01/2020 |