Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC010707 | PA |
NPI | 1316346448 |
---|---|
Provider Name | Laurie Rickle |
First Address | Pittsburgh, PA 15211-2322 |
Second Address | Oakmont, PA 15139-2005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2014 |
Last Update Date | 14/08/2014 |