Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC007254L | PA |
NPI | 1003948415 |
---|---|
Provider Name | Melissa Gehlman |
First Address | Windber, PA 15963-9116 |
Second Address | Johnstown, PA 15901-1608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 22/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0019643420002 | (05) | PA |