Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OC010474 | PA |
NPI | 1386950459 |
---|---|
Provider Name | Mrs. Andrea L Mertz |
First Address | Danville, PA 17821-8517 |
Second Address | Orangeville, PA 17859-9064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2010 |
Last Update Date | 26/08/2010 |