Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 19278 | CA |
N | 225XG0600X | Occupational Therapist - Gerontology | 19278 | CA |
NPI | 1871122200 |
---|---|
Provider Name | Shelby Lynn Hunter |
First Address | Chino Hills, CA 91709-2018 |
Second Address | Chino Hills, CA 91709-2018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2020 |
Last Update Date | 07/04/2020 |