Individual
ELLYN SUE GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OP000524L
PA
224Z00000X
Occupational Therapy Assistant
Primary
U2-0000644
DE
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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