Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP003677L | PA |
NPI | 1013384569 |
---|---|
Provider Name | Mrs. Laurie Baughman |
First Address | Somerset, PA 15501-7055 |
Second Address | Somerset, PA 15501-7055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2015 |
Last Update Date | 31/08/2015 |