Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 05394 | MD |
NPI | 1548930829 |
---|---|
Provider Name | Mrs. Amy Liu |
First Address | Baltimore, MD 21215-5267 |
Second Address | Baltimore, MD 21215-5267 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2021 |
Last Update Date | 17/09/2021 |