| NPI | 1861638728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: CA OT 1173) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA OT 1173) |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: CA OT 1173) | |
| 314000000X Skilled Nursing Facility (Licence: CA OT 1173) | |
| Enumeration Date | 2008-12-25 |
| Last Update Date | 2008-12-25 |