Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC000727L | PA |
NPI | 1003923228 |
---|---|
Provider Name | Mrs. Louise R Miller |
First Address | Reading, PA 19609 |
Second Address | Reading, PA 19609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0173599000 | KEYSTONE HEALTH PLAN CENT (01) | PA |
50056661 | CAPITAL BLUE CROSS (01) | PA |