Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 708 | CA |
NPI | 1467657676 |
---|---|
Provider Name | Clarissa Cowan |
First Address | San Diego, CA 92107-3914 |
Second Address | San Diego, CA 92123-1637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 30/11/2021 |