Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 1145 | CA |
NPI | 1073718540 |
---|---|
Provider Name | Ms. Marianne S Outzen |
First Address | Los Altos, CA 94024-6119 |
Second Address | Palo Alto, CA 94304-2201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 08/07/2007 |