Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 19887 | CA |
NPI | 1245891050 |
---|---|
Provider Name | Louisa Nkwuaku |
First Address | Carson, CA 90746-1518 |
Second Address | Anaheim, CA 92804-3708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2019 |
Last Update Date | 23/06/2019 |