Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 10312 | CA |
NPI | 1255810867 |
---|---|
Provider Name | Saran Nuth |
First Address | Santa Rosa, CA 95403-2315 |
Second Address | Santa Rosa, CA 95403-2315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2018 |
Last Update Date | 14/08/2018 |