Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | OC012891 | PA |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC012891 | PA |
NPI | 1265988174 |
---|---|
Provider Name | Mrs. Christine Charlotte Estelle |
First Address | Bethlehem, PA 18017-8931 |
Second Address | King Of Prussia, PA 19406-2802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2016 |
Last Update Date | 06/06/2019 |