Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 1637 | CA |
NPI | 1053527986 |
---|---|
Provider Name | Emily Rebecca Levine |
First Address | Sherman Oaks, CA 91423-2158 |
Second Address | Los Angeles, CA 90064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 14/05/2018 |