Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CA2400X | Assistive Technology Practitioner | PA | |
N | 225CX0006X | Orientation and Mobility Training Provider | PA | |
Y | 225X00000X | Occupational Therapist | OC008552 | PA |
N | 225XE0001X | Environmental Modification | OC008552 | PA |
N | 225XF0002X | Feeding, Eating & Swallowing | OC008552 | PA |
N | 225XG0600X | Occupational Therapist - Gerontology | OC008552 | PA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OC008552 | PA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC008552 | PA |
N | 225XR0403X | Driving and Community Mobility | OC008552 | PA |
NPI | 1497996268 |
---|---|
Provider Name | Reuben S Balasundram |
First Address | Mechanicsburg, PA 17050-7954 |
Second Address | Mechanicsburg, PA 17050-7954 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2009 |
Last Update Date | 15/05/2009 |