Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | A01464 | MD |
NPI | 1013287804 |
---|---|
Provider Name | Michelle Andrews |
First Address | Columbia, MD 21046-1703 |
Second Address | Baltimore, MD 21239-3932 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2012 |
Last Update Date | 10/01/2012 |