Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 19534 | CA |
NPI | 1003447715 |
---|---|
Provider Name | Jacqueline Marie Mcintosh |
First Address | San Francisco, CA 94116-1528 |
Second Address | San Francisco, CA 94116-1528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2020 |
Last Update Date | 31/01/2020 |