Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner |
NPI | 1083253660 |
---|---|
Provider Name | Sydney Laurel Huestis |
First Address | Stockton, CA 95202-1552 |
Second Address | Stockton, CA 95202-1552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2019 |
Last Update Date | 31/12/2019 |