Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC-000902L | PA |
NPI | 1033422399 |
---|---|
Provider Name | Ms. Lisa A Baum |
First Address | Cheltenham, PA 19012-1015 |
Second Address | Cheltenham, PA 19012-1015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2010 |
Last Update Date | 15/07/2010 |