Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 7555 | CA |
NPI | 1033359161 |
---|---|
Provider Name | Michelle Alyssa Kuwabara |
First Address | Torrance, CA 90504-4515 |
Second Address | Torrance, CA 90504-4515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2009 |
Last Update Date | 02/03/2009 |