Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT6144 | CA |
N | 225XG0600X | Occupational Therapist - Gerontology | ||
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1679106280 |
---|---|
Provider Name | Roslynn Koran |
First Address | Westlake Village, CA 91361-5673 |
Second Address | Westlake Village, CA 91361-5673 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2020 |
Last Update Date | 21/02/2020 |