Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 174 | CA |
NPI | 1255425781 |
---|---|
Provider Name | Ms. Melody Ann Newcombe |
First Address | Capitola, CA 95010 |
Second Address | Santa Cruz, CA 95060 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |