Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 20189 | CA |
NPI | 1003450495 |
---|---|
Provider Name | Adee Rozov |
First Address | Long Beach, CA 90803-5424 |
Second Address | Irvine, CA 92612-8535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2019 |
Last Update Date | 30/10/2019 |