Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP001588L | PA |
NPI | 1013034123 |
---|---|
Provider Name | Mrs. Barbara Marie Mitchell |
First Address | Boyertown, PA 19512-7915 |
Second Address | Boyertown, PA 19512-7915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 06/11/2013 |