Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003424755 |
---|---|
Provider Name | Laura Overman |
First Address | Frederick, MD 21704-7946 |
Second Address | Cambridge, MD 21613-1414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2020 |
Last Update Date | 20/07/2020 |