Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003392721 |
---|---|
Provider Name | Amy Sadek |
First Address | San Clemente, CA 92673-6250 |
Second Address | San Clemente, CA 92673-6250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2018 |
Last Update Date | 16/07/2018 |