Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 1502 | CA |
NPI | 1114698370 |
---|---|
Provider Name | Sarah L Adkisson |
First Address | Lakeside, CA 92040-5820 |
Second Address | San Diego, CA 92131-1120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2021 |
Last Update Date | 27/09/2021 |