Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT 4207 | CA |
NPI | 1932184116 |
---|---|
Provider Name | Mr. Robin Reginald Hershey |
First Address | Sacramento, CA 95829-6002 |
Second Address | Sacramento, CA 95817-2201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2005 |
Last Update Date | 08/07/2007 |