Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC000849L | PA |
N | 225XG0600X | Occupational Therapist - Gerontology | OC000849L | PA |
NPI | 1558506170 |
---|---|
Provider Name | Ms. Terryl Lea Marsh |
First Address | King Of Prussia, PA 19406-1571 |
Second Address | King Of Prussia, PA 19406-1571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2008 |
Last Update Date | 10/12/2008 |