Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OC000093L | PA |
Y | 225XH1200X | Occupational Therapist - Hand | OC0000993L | PA |
NPI | 1265509640 |
---|---|
Provider Name | Ms. Marianne K. Dunphy |
First Address | King Of Prussia, PA 19406-3530 |
Second Address | King Of Prussia, PA 19406-3530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 23/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0983863000 | IBC - KEYSTONE (01) | PA |
759715 | IBC - PERSONAL CHOICE (01) | PA |