Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1407391048 |
---|---|
Provider Name | Mrs. Carli Mcgoff |
First Address | Silver Spring, MD 20902-2468 |
Second Address | Silver Spring, MD 20902-2468 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2017 |
Last Update Date | 05/01/2017 |