Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OC002813L | PA |
NPI | 1013126309 |
---|---|
Provider Name | Mrs. Carol Lynn Gardner |
First Address | Easton, PA 18045-8338 |
Second Address | Easton, PA 18045-8338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |