Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | AA000310 | CA |
NPI | 1265630149 |
---|---|
Provider Name | Melissa A Thayer |
First Address | Pasadena, CA 91188-0001 |
Second Address | Los Angeles, CA 90034-1702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 08/07/2007 |