Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT 1922 | CA |
NPI | 1093862765 |
---|---|
Provider Name | Audrey Vl Suciu |
First Address | Saratoga, CA 95070-6341 |
Second Address | Santa Clara, CA 95051-5173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 03/01/2022 |