Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 06144 | MD |
NPI | 1003037847 |
---|---|
Provider Name | Ms. Eleanor Holston Ham |
First Address | Bethesda, MD 20814-3028 |
Second Address | Bethesda, MD 20814-3028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 20/05/2011 |