Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OC013583 | PA |
NPI | 1407456999 |
---|---|
Provider Name | Kristen M Bullers |
First Address | York, PA 17404-5005 |
Second Address | York, PA 17403-5023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2020 |
Last Update Date | 26/10/2020 |