Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 12182 | CA |
NPI | 1538672944 |
---|---|
Provider Name | Anabelle Escueta Canty |
First Address | Vallejo, CA 94591-7115 |
Second Address | Vacaville, CA 95687-4100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2017 |
Last Update Date | 07/11/2017 |