Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 10598 | CA |
NPI | 1598085284 |
---|---|
Provider Name | Cecile Wildin |
First Address | San Francisco, CA 94133-2054 |
Second Address | San Francisco, CA 94133-2054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2010 |
Last Update Date | 04/06/2010 |