Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033501879 |
---|---|
Provider Name | Linsay Siomara Rodriguez Montenegro |
First Address | Long Beach, CA 90810-1876 |
Second Address | Long Beach, CA 90810-1876 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2015 |
Last Update Date | 03/03/2015 |