| NPI | 1871900837 |
|---|---|
| Former Name | SHASTA DO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: OH OTA005564) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: OH ota.05564) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2022-06-29 |