Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1867 | CA |
NPI | 1194264101 |
---|---|
Provider Name | Mrs. Janet K. Walitka |
First Address | Palmdale, CA 93551 |
Second Address | Palmdale, CA 93551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2017 |
Last Update Date | 23/02/2017 |