Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5570 | CA |
NPI | 1033793898 |
---|---|
Provider Name | Danielle Ann |
First Address | Long Beach, CA 90806-1551 |
Second Address | Long Beach, CA 90806-1551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2021 |
Last Update Date | 07/05/2021 |