Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT5103 | CA |
NPI | 1013906080 |
---|---|
Provider Name | Mrs. Julie Williamson |
First Address | Larkspur, CA 94939-1143 |
Second Address | Larkspur, CA 94939-1143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 11/02/2022 |