Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC008690 | PA |
N | 225XG0600X | Occupational Therapist - Gerontology | OC008690 | PA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC008690 | PA |
NPI | 1932474699 |
---|---|
Provider Name | Toya M Hines |
First Address | Aldan, PA 19018-4311 |
Second Address | Philadelphia, PA 19145-2328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2012 |
Last Update Date | 14/03/2012 |