Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 10782 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | 10782 | CA |
N | 2251H1200X | Hand | 10782 | CA |
N | 2251H1300X | Human Factors | 10782 | CA |
N | 225XH1300X | Human Factors | 10782 | CA |
Y | 2251P0200X | Physical Therapist - Pediatrics | 10782 | CA |
NPI | 1114263662 |
---|---|
Provider Name | Ms. Maureen Beekman Wolf |
First Address | Torrance, CA 90505-2855 |
Second Address | Torrance, CA 90505-2855 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2013 |
Last Update Date | 02/01/2013 |