Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 4459 | CA |
N | 225XH1200X | Occupational Therapist - Hand | 4459 | CA |
NPI | 1003866492 |
---|---|
Provider Name | Teri Haskins |
First Address | Carlsbad, CA 92010-5556 |
Second Address | Vista, CA 92081-6024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 25/10/2018 |