Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 06157 | MD |
NPI | 1851857809 |
---|---|
Provider Name | Lorraine Prosser Elliott |
First Address | Salisbury, MD 21801-2521 |
Second Address | Princess Anne, MD 21853-2105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2019 |
Last Update Date | 14/02/2019 |