Individual
CAROLYN TRACY LIU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
976 DIAZ LN, FOSTER CITY, CA 94404-2911
(650) 888-5712
Mailing address
976 DIAZ LN, FOSTER CITY, CA 94404-2911
(650) 888-5712
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
225X00000X
Occupational Therapist
16379
CA
Other
Enumeration date
04/19/2018
Last updated
11/05/2018
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