Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 3780 | CA |
NPI | 1871713248 |
---|---|
Provider Name | Ms. Maureen Carol Bern |
First Address | Colfax, CA 95713-9606 |
Second Address | Auburn, CA 95603-4525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 08/07/2007 |