Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 2042 | CA |
NPI | 1184962490 |
---|---|
Provider Name | Mrs. Lotus Lustig Halbower |
First Address | San Leandro, CA 94577-4201 |
Second Address | San Leandro, CA 94577-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2013 |
Last Update Date | 03/01/2022 |