Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1013444249 |
---|---|
Provider Name | Deborah Chambers |
First Address | Commerce, CA 90040-2453 |
Second Address | Commerce, CA 90040-2453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2017 |
Last Update Date | 18/05/2017 |