Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 590 | CA |
NPI | 1982705943 |
---|---|
Provider Name | Ms. Susan Annette Smiley |
First Address | Hayward, CA 94541-3132 |
Second Address | San Leandro, CA 94578-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |