Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OC009764 | PA |
NPI | 1003567413 |
---|---|
Provider Name | Trisn Hopkins |
First Address | Du Bois, PA 15801-9028 |
Second Address | Du Bois, PA 15801-3986 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2022 |
Last Update Date | 17/01/2022 |