Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CA2400X | Assistive Technology Practitioner |
NPI | 1275651580 |
---|---|
Provider Name | Mrs. Shawna Lee Bryant |
First Address | Orange, CA 92866-2105 |
Second Address | Long Beach, CA 90802-2426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 08/07/2007 |