Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | TOP007905 | PA |
NPI | 1003019985 |
---|---|
Provider Name | Miss Kayla Marie Welsh |
First Address | Lititz, PA 17543-8561 |
Second Address | Mount Joy, PA 17552-9663 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 08/07/2007 |