Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 5830 | CA |
NPI | 1043346547 |
---|---|
Provider Name | Mr. Cheryl Garden |
First Address | Los Angeles, CA 90035-2058 |
Second Address | Los Angeles, CA 90035-2058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |