Provider Demographics
NPI:1255410767
Name:DEWITT, MARY HELEN (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:HELEN
Last Name:DEWITT
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Gender:F
Credentials:OCCUPATIONAL THERAPI
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Mailing Address - Street 1:1530 3RD ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-1562
Mailing Address - Country:US
Mailing Address - Phone:916-434-9572
Mailing Address - Fax:916-434-9063
Practice Address - Street 1:1530 3RD ST
Practice Address - Street 2:SUITE 211
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-1562
Practice Address - Country:US
Practice Address - Phone:916-434-9572
Practice Address - Fax:916-434-9063
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA5792224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant