Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 12258 |
NPI | 1013287317 |
---|---|
Provider Name | Audrey Baik |
First Address | North Hollywood, CA 91606 |
Second Address | North Hollywood, CA 91606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2012 |
Last Update Date | 04/01/2012 |