Individual
LATA ANANTHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1350 BUCK TRAIL RD, ALLENTOWN, PA 18104-2049
(610) 391-1812
Mailing address
1350 BUCK TRAIL RD, ALLENTOWN, PA 18104-2049
(610) 391-1812
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006594
PA
Other
Enumeration date
12/06/2008
Last updated
12/06/2008
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