Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1003948159 |
---|---|
Provider Name | Sheila Renee Hartman |
First Address | Los Angeles, CA 90047-3206 |
Second Address | Los Angeles, CA 90037-3527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 08/07/2007 |