Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT 2595 | CA |
NPI | 1245328301 |
---|---|
Provider Name | Janet Gail Waylett-Rendall |
First Address | Riverside, CA 92507-0728 |
Second Address | Riverside, CA 92507-0728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/05/2008 |