Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 4404 | CA |
NPI | 1245403641 |
---|---|
Provider Name | Sarah Ann Sizemore |
First Address | Santa Rosa, CA 95403 |
Second Address | Santa Rosa, CA 95403-2149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2008 |
Last Update Date | 07/04/2008 |