Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC012689 | PA |
NPI | 1063844736 |
---|---|
Provider Name | Ms. Sara Ravier |
First Address | Bethlehem, PA 18017-3244 |
Second Address | Bethlehem, PA 18017-3244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2013 |
Last Update Date | 05/08/2013 |