Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | ||
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT00002288 | CA |
NPI | 1942485107 |
---|---|
Provider Name | Mrs. Elsabe Amelia Kruger |
First Address | Fresno, CA 93720-3833 |
Second Address | Fresno, CA 93720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2008 |
Last Update Date | 12/01/2009 |