Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 02893 | MD |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 02893 | MD |
NPI | 1346588829 |
---|---|
Provider Name | Pamela Jean O' Baker |
First Address | Kennett Square, PA 19348-3109 |
Second Address | Frostburg, MD 21532-2009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2013 |
Last Update Date | 07/06/2013 |