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Individual
SPENCER SANDAGE
Active
Individual
SPENCER SANDAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17847
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17847
OT LICENSE
CA
Enumeration date
01/31/2020
Last updated
11/12/2021
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