Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC010647 | PA |
NPI | 1073782421 |
---|---|
Provider Name | Mrs. Linee Marie Tourdot |
First Address | Bridgeville, PA 15017-1220 |
Second Address | Pittsburgh, PA 15237-6020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2008 |
Last Update Date | 29/02/2008 |