Individual
KHUTSO ANNAH MODIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BACHELOR
Contact information
Practice address
2400 KINGSTON CT, YORK, PA 17402-3650
(813) 776-2504
Mailing address
119 W BALTIMORE AVE APT 7B, LANSDOWNE, PA 19050-1848
(661) 496-2789
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
0C009705
PA
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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