Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 20720 | CA |
NPI | 1003584731 |
---|---|
Provider Name | Keene Liang |
First Address | Rosemead, CA 91770-1903 |
Second Address | Pasadena, CA 91107-6617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2021 |
Last Update Date | 30/08/2021 |