Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | 0119004914 | VA |
N | 225XH1200X | Occupational Therapist - Hand | 5269 | MA |
Y | 225XH1200X | Occupational Therapist - Hand | OT 12138 | CA |
NPI | 1255665709 |
---|---|
Provider Name | Sylvia Puttick Rodrigues |
First Address | Fairfield, CA 94533-9795 |
Second Address | Alexandria, VA 22304-3418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2009 |
Last Update Date | 05/12/2011 |