Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT3611 | CA |
NPI | 1720286065 |
---|---|
Provider Name | Susan Elizabeth Hannigan |
First Address | Santa Barbara, CA 93111-1113 |
Second Address | Santa Barbara, CA 93111-1113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2007 |
Last Update Date | 09/07/2007 |