Individual
MAHA BASIDIQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
562 SANTA CRUZ CT, SANTA MARIA, CA 93455-1750
(559) 285-6664
Mailing address
562 SANTA CRUZ CT, SANTA MARIA, CA 93455-1750
(559) 285-6664
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
373
CA
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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