Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 13826 | CA |
NPI | 1013208248 |
---|---|
Provider Name | Mrs. Amanda Michelle Littlejohn |
First Address | Gardena, CA 90248-3523 |
Second Address | Torrance, CA 90505-6660 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2011 |
Last Update Date | 18/01/2022 |