Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 010000789 | DC |
NPI | 1003248527 |
---|---|
Provider Name | Petra Doyle |
First Address | Washington, DC 20002-6153 |
Second Address | Washington, DC 20002-6153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2013 |
Last Update Date | 07/08/2013 |