Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 6480 | CA |
NPI | 1063776235 |
---|---|
Provider Name | Patricia Hanczuk |
First Address | Monrovia, CA 91016-3431 |
Second Address | Monrovia, CA 91016-3431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2012 |
Last Update Date | 02/07/2012 |