Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 0T 1771 | CA |
NPI | 1063559888 |
---|---|
Provider Name | Anita Castain Banks |
First Address | Martinez, CA 94553-4614 |
Second Address | Martinez, CA 94553-4614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 08/07/2007 |