Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 13073 | CA |
NPI | 1053654905 |
---|---|
Provider Name | Michaelann Gabriele |
First Address | Torrance, CA 90501-2852 |
Second Address | Torrance, CA 90501-2852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 28/03/2013 |