Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT00003998 | WA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT9996 | CA |
NPI | 1255549515 |
---|---|
Provider Name | Ms. Sandra Min Siow |
First Address | Long Beach, CA 90802 |
Second Address | Long Beach, CA 90802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 30/04/2014 |