Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC000871L | PA |
N | 225XE0001X | Environmental Modification | OC000871L | PA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OC000871L | PA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC000871L | PA |
NPI | 1003183468 |
---|---|
Provider Name | Mrs. Renee Magida |
First Address | Abington, PA 19001-2103 |
Second Address | Abington, PA 19001-2103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2011 |
Last Update Date | 29/11/2011 |