Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 001795 | PA |
NPI | 1053409524 |
---|---|
Provider Name | Ms. Lisa Kay Hoffman |
First Address | Airville, PA 17302-9463 |
Second Address | York, PA 17402-2773 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1007266430007 | (05) | PA |