Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 19710 | CA |
NPI | 1033675483 |
---|---|
Provider Name | Dr. Emily Dolores Grullon |
First Address | Arcadia, CA 91007-3492 |
Second Address | Arcadia, CA 91007-3492 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2019 |
Last Update Date | 22/02/2019 |