Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT 8087 | CA |
NPI | 1023182797 |
---|---|
Provider Name | Mrs. Julie Ann Evans |
First Address | Fresno, CA 93720-2938 |
Second Address | Fresno, CA 93720-2938 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 25/09/2015 |