Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
Y | 225XG0600X | Occupational Therapist - Gerontology | OC008735 | PA |
NPI | 1386076669 |
---|---|
Provider Name | Mrs. Joanna Bednar |
First Address | Coal Township, PA 17866-9405 |
Second Address | Coal Township, PA 17866-9405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2013 |
Last Update Date | 08/08/2013 |