Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 20108 | CA |
N | 225XE0001X | Environmental Modification | 20108 | CA |
N | 2251E1200X | Ergonomics | 20108 | CA |
N | 225XE1200X | Ergonomics | 20108 | CA |
Y | 225XH1200X | Occupational Therapist - Hand | 20108 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 20108 | CA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 20108 | CA |
N | 225XP0200X | Occupational Therapist - Pediatrics | 20108 | CA |
NPI | 1720648298 |
---|---|
Provider Name | Josephine Mickelsen |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Valencia, CA 91355-5702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2019 |
Last Update Date | 01/10/2021 |