Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 568 | CA |
NPI | 1821155250 |
---|---|
Provider Name | Ms. Maria Michaela Reisert |
First Address | Oakland, CA 94611-5642 |
Second Address | Oakland, CA 94611-5311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 30/12/2021 |