Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1013455179 |
---|---|
Provider Name | Toni Wright |
First Address | Hawthorne, CA 90250-8234 |
Second Address | Los Angeles, CA 90059-2897 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2017 |
Last Update Date | 02/10/2018 |