Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 24603 | CA |
NPI | 1134351695 |
---|---|
Provider Name | Robin Lorinne Clarkson |
First Address | La Verne, CA 91750 |
Second Address | La Verne, CA 91750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2009 |
Last Update Date | 18/08/2009 |