Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC010329 | PA |
NPI | 1003027616 |
---|---|
Provider Name | Nadine Hepburn |
First Address | Drexel Hill, PA 19026-1018 |
Second Address | Drexel Hill, PA 19026-1018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 08/07/2007 |