Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | 019823-1 | NY |
Y | 225XH1200X | Occupational Therapist - Hand | 16340 | CA |
NPI | 1134591183 |
---|---|
Provider Name | Jamie Rome Rosenblum |
First Address | Culver City, CA 90232-3448 |
Second Address | Santa Monica, CA 90405-1026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2015 |
Last Update Date | 23/08/2021 |