Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 9236 | CA |
NPI | 1023517497 |
---|---|
Provider Name | Marilyn L Ziegler |
First Address | Lake Arrowhead, CA 92352-0070 |
Second Address | Lake Arrowhead, CA 92352 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2018 |
Last Update Date | 12/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A2564668 | DRIVER'S LICENSE (01) | CA |