Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1003076977 |
---|---|
Provider Name | Mary Kathryn Urell |
First Address | Chino Hills, CA 91709-3330 |
Second Address | Los Angeles, CA 90001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2008 |
Last Update Date | 13/06/2008 |