Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 1121 | CA |
Y | 225XH1200X | Occupational Therapist - Hand | 1121 | CA |
NPI | 1184869000 |
---|---|
Provider Name | Mrs. Lyndsey Ann Kinane |
First Address | Petaluma, CA 94952-7404 |
Second Address | Petaluma, CA 94952-7404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2008 |
Last Update Date | 30/11/2010 |