Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OC011751 | PA |
NPI | 1790030831 |
---|---|
Provider Name | Mrs. Ashley N Anthony |
First Address | Pottsville, PA 17901-3862 |
Second Address | Pottsville, PA 17901-3862 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 16/07/2012 |