Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1376053868 |
---|---|
Provider Name | Elizabeth Soria |
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 | 10/10/2017 |
Last Update Date | 10/10/2017 |