Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 15538 | CA |
NPI | 1174997159 |
---|---|
Provider Name | Cassandra Hudson |
First Address | Los Angeles, CA 90045-4833 |
Second Address | Los Angeles, CA 90045-4833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2015 |
Last Update Date | 14/11/2015 |