Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC009359 | PA |
NPI | 1033364229 |
---|---|
Provider Name | Mrs. Krista D Dipaolo |
First Address | Ivyland, PA 18974-1740 |
Second Address | Ivyland, PA 18974-1740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2008 |
Last Update Date | 01/12/2008 |