Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC012469 | PA |
NPI | 1003160961 |
---|---|
Provider Name | Rafaela Reyna |
First Address | Pittsburgh, PA 15217-2950 |
Second Address | Pittsburgh, PA 15217-2950 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2012 |
Last Update Date | 30/10/2012 |