Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OC006138L | PA |
NPI | 1336444603 |
---|---|
Provider Name | Mary Ann Quinn |
First Address | Uniontown, PA 15401-3253 |
Second Address | Uniontown, PA 15401-3253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2011 |
Last Update Date | 01/08/2012 |