Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 9121 | CA |
NPI | 1083137376 |
---|---|
Provider Name | Jenny Sunah Lee |
First Address | Downey, CA 90242-3456 |
Second Address | Downey, CA 90242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2017 |
Last Update Date | 19/07/2017 |