Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2413 | CA |
NPI | 1770098329 |
---|---|
Provider Name | Lucy Dodakian |
First Address | Irvine, CA 92697-0001 |
Second Address | Irvine, CA 92697-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2017 |
Last Update Date | 05/12/2017 |