Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 4238 | CA |
NPI | 1013128164 |
---|---|
Provider Name | Ms. Randi Jeanne Walker |
First Address | Redlands, CA 92373-5162 |
Second Address | Loma Linda, CA 92354-3711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/07/2007 |