Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC008955 | PA |
NPI | 1003068602 |
---|---|
Provider Name | Suzanne Kerstin Mcgloin |
First Address | King Of Prussia, PA 19406-1571 |
Second Address | Lafayette Hill, PA 19444-2502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2008 |
Last Update Date | 14/11/2008 |