Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 04604 | MD |
NPI | 1336738954 |
---|---|
Provider Name | Mrs. Robin Jennifer Mitchell |
First Address | Catonsville, MD 21228-4706 |
Second Address | Catonsville, MD 21228-4706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2021 |
Last Update Date | 18/01/2021 |