Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 1039941 | CA |
NPI | 1992737597 |
---|---|
Provider Name | Rosalie Dela Cruz Manuel |
First Address | Panorama City, CA 91402-5130 |
Second Address | Panorama City, CA 91402-5130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 05/10/2007 |