| NPI | 1639579758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE N. CORN Owner 916-791-2747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CA PT684) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: CA OT7936) |
| 225XF0002X Occupational Therapist, Feeding, Eating & Swallowing (Licence: CA OT7936) | |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2014-11-13 |