Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC012833 | PA |
NPI | 1063835965 |
---|---|
Provider Name | Mrs. Sarah Rice Glezman |
First Address | Hellertown, PA 18055-3042 |
Second Address | Coopersburg, PA 18036-2027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2014 |
Last Update Date | 28/01/2014 |