Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT 5200 |
NPI | 1598917783 |
---|---|
Provider Name | Donna L Mills |
First Address | Riverside, CA 92505-3044 |
Second Address | Riverside, CA 92505-3044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 21/10/2008 |