Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OC004886L | PA |
Y | 225XM0800X | Mental Health | OC004886L | PA |
NPI | 1598723967 |
---|---|
Provider Name | Raymond Busch |
First Address | Pittsburgh, PA 15214-1218 |
Second Address | Pittsburgh, PA 15213-2561 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 29/03/2021 |