Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 7372 | CA |
NPI | 1265756019 |
---|---|
Provider Name | Ms. Michelle Miles-Kessell |
First Address | San Diego, CA 92131-3227 |
Second Address | San Diego, CA 92127-1603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2010 |
Last Update Date | 22/11/2020 |