Individual
BETSY MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 BODIN CIR, FAIRFIELD, CA 94535-1809
(707) 423-7899
Mailing address
101 BODIN CIR, FAIRFIELD, CA 94535-1809
(707) 423-7899
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
4664
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4664
OCCUPATIONAL THERAPIST
CA
Enumeration date
01/19/2010
Last updated
11/30/2018
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