Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 1105 | CA |
Y | 225XG0600X | Occupational Therapist - Gerontology | 1105 | CA |
N | 225XL0004X | Low Vision | 1105 | CA |
NPI | 1568604775 |
---|---|
Provider Name | Miss Eileen Dale Misrahi |
First Address | Oak Park, CA 91377-4773 |
Second Address | Oak Park, CA 91377-4773 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 02/04/2009 |