Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 4163 | CA |
NPI | 1003212622 |
---|---|
Provider Name | Ms. Peggy Bell-Hans |
First Address | Arcata, CA 95521-5055 |
Second Address | Arcata, CA 95521-5055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2014 |
Last Update Date | 10/11/2014 |