Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 6442 | CA |
NPI | 1235168717 |
---|---|
Provider Name | Mrs. Cindy Clayton Gracely |
First Address | Walnut Creek, CA 94596-5417 |
Second Address | Pinole, CA 94564-2524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 08/07/2007 |