Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 15756 | CA |
NPI | 1003289703 |
---|---|
Provider Name | Dr. Elizabeth Pauly |
First Address | El Segundo, CA 90245-8169 |
Second Address | El Segundo, CA 90245-5052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2015 |
Last Update Date | 10/07/2021 |