Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 05755 | MD |
NPI | 1003072968 |
---|---|
Provider Name | Miss Samora Casimir |
First Address | Baltimore, MD 21206-3710 |
Second Address | Washington, DC 20307-0003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2008 |
Last Update Date | 31/07/2008 |