Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 11010 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 11010 | CA |
NPI | 1114271731 |
---|---|
Provider Name | Sarah Titlow |
First Address | Playa Del Rey, CA 90293-7960 |
Second Address | Playa Del Rey, CA 90293-7960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2012 |
Last Update Date | 05/11/2012 |