Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 11027 | CA |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 11027 | CA |
NPI | 1821481805 |
---|---|
Provider Name | Lorie Brinkman |
First Address | Los Angeles, CA 90034-4450 |
Second Address | Los Angeles, CA 90034-4450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2015 |
Last Update Date | 14/03/2015 |