Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 13174 | CA |
N | 225X00000X | Occupational Therapist | 6976 | MA |
N | 225XE0001X | Environmental Modification | ||
N | 2251E1200X | Ergonomics | ||
N | 225XE1200X | Ergonomics | ||
N | 225XM0800X | Mental Health | ||
N | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1093056640 |
---|---|
Provider Name | Ms. Dawn Koren Stevenson |
First Address | Grass Valley, CA 95945-4300 |
Second Address | Auburn, CA 95603-2413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2013 |
Last Update Date | 06/03/2013 |