Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT 5666 | CA |
NPI | 1023257995 |
---|---|
Provider Name | Heather Hudgins |
First Address | Redondo Beach, CA 90278-3942 |
Second Address | Torrance, CA 90504-4515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2009 |
Last Update Date | 16/02/2009 |