Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 3763 | CA |
NPI | 1891949285 |
---|---|
Provider Name | Mrs. Isabel Mullin |
First Address | Manhattan Beach, CA 90266-5218 |
Second Address | Manhattan Beach, CA 90266-5218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2008 |
Last Update Date | 11/11/2008 |