Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP007670 | PA |
NPI | 1023415247 |
---|---|
Provider Name | Linda Thomas |
First Address | Huntingdon, PA 16652-1518 |
Second Address | Spring City, PA 19475-1241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2014 |
Last Update Date | 03/12/2014 |