Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC007139L | PA |
NPI | 1316494941 |
---|---|
Provider Name | Mrs. Kathryn Roberts |
First Address | Gibsonia, PA 15044-9605 |
Second Address | Gibsonia, PA 15044-9605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2016 |
Last Update Date | 01/09/2016 |