Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OC011992 | PA |
Y | 225XH1200X | Occupational Therapist - Hand | OC011992 | PA |
NPI | 1154879468 |
---|---|
Provider Name | Ms. Lauren Cook |
First Address | Allentown, PA 18104-9147 |
Second Address | Allentown, PA 18104-9147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2016 |
Last Update Date | 15/09/2016 |