Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT7196 | CA |
NPI | 1023176450 |
---|---|
Provider Name | Carolyn Bartlett |
First Address | Santa Rosa, CA 95405-4557 |
Second Address | Santa Rosa, CA 95405-4557 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 24/11/2010 |