Organization
M63 INC.
Active
Other names
Brainasium
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN MOSS (PRESIDENT)
(916) 780-1818
Entity
Organization
Contact information
Practice address
9085 AUBURN FOLSOM RD, GRANITE BAY, CA 95746-9656
(916) 780-1818
(916) 780-2112
Mailing address
9085 AUBURN FOLSOM RD, GRANITE BAY, CA 95746-9656
(916) 780-1818
(916) 780-2112
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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