Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 3208 | CA |
NPI | 1003163650 |
---|---|
Provider Name | Claire Amos |
First Address | Auburn, CA 95603-0000 |
Second Address | Auburn, CA 95603-3831 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2012 |
Last Update Date | 13/08/2012 |