Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 4230 | CA |
NPI | 1134525322 |
---|---|
Provider Name | Susan Wright |
First Address | Sacramento, CA 95827-2539 |
Second Address | Jackson, CA 95642-2154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2014 |
Last Update Date | 24/07/2015 |