Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 4528 | CA |
NPI | 1376625350 |
---|---|
Provider Name | Siobhan Marie O Hurley |
First Address | Redding, CA 96003-8628 |
Second Address | Redding, CA 96002-2005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q58756 | (02) | CA |