Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC001096L | PA |
NPI | 1003014424 |
---|---|
Provider Name | Ms. Cheryl Gleason |
First Address | Mechanicsburg, PA 17055-4484 |
Second Address | Duncannon, PA 17020-9745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2007 |
Last Update Date | 08/07/2007 |