Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC002979 | PA |
NPI | 1003025719 |
---|---|
Provider Name | Ms. Carolyn Marie Gatty |
First Address | Mifflinburg, PA 17844-7331 |
Second Address | Williamsport, PA 17701-1669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |