Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 20176 | CA |
NPI | 1003468943 |
---|---|
Provider Name | Kelsey Dawn Zambraski |
First Address | Lagrangeville, NY 12540-6814 |
Second Address | Petaluma, CA 94952-4028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2019 |
Last Update Date | 12/07/2019 |