Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 12307 | CA |
N | 225XM0800X | Mental Health | 12307 | CA |
NPI | 1952622730 |
---|---|
Provider Name | Yoonie Eady |
First Address | Gardena, CA 90248-3523 |
Second Address | Gardena, CA 90248-3523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2010 |
Last Update Date | 12/09/2018 |