Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 9606 | CA |
NPI | 1003183096 |
---|---|
Provider Name | Diana E Melendez |
First Address | La Quinta, CA 92253 |
Second Address | Palm Desert, CA 92211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2011 |
Last Update Date | 19/11/2011 |