Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 017232 | NY |
NPI | 1023376555 |
---|---|
Provider Name | Mary Katherine Bohlin |
First Address | Brooklyn, NY 11204-1809 |
Second Address | Brooklyn, NY 11204-1809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2012 |
Last Update Date | 03/05/2012 |