Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC014227 | PA |
NPI | 1043732977 |
---|---|
Provider Name | Ms. Kristin Sims |
First Address | Trevose, PA 19053-6940 |
Second Address | Trevose, PA 19053-6940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2017 |
Last Update Date | 12/07/2017 |