Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1003077694 |
---|---|
Provider Name | Miss Autumn Nicole Gauna |
First Address | Pasadena, CA 91101-1109 |
Second Address | North Hollywood, CA 91601-3184 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2008 |
Last Update Date | 10/05/2013 |