Provider Demographics
NPI:1952660029
Name:LANDINI, MARGARET J
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:J
Last Name:LANDINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5685 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KELSEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95451-8945
Mailing Address - Country:US
Mailing Address - Phone:707-279-8733
Mailing Address - Fax:707-279-8731
Practice Address - Street 1:5685 MAIN ST
Practice Address - Street 2:
Practice Address - City:KELSEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95451-8945
Practice Address - Country:US
Practice Address - Phone:707-279-8733
Practice Address - Fax:707-279-8731
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 743225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOT 743OtherCALIFORNIA BOARD OF OCCUPATIONAL THERAPY LICENSE