Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP003142L | PA |
NPI | 1023342599 |
---|---|
Provider Name | Miss Kara Diane Trettel |
First Address | New Castle, PA 16101-5970 |
Second Address | New Castle, PA 16101-5970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2009 |
Last Update Date | 30/09/2009 |