| NPI | 1609110378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACHEL FREEL Owner/Director 805-729-1992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: CA OT4310) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT32974) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: CA OT6386) | |
| 235Z00000X Speech-Language Pathologist, (Licence: CA SP11393) | |
| 235Z00000X Speech-Language Pathologist, (Licence: SP15963) | |
| 252Y00000X Early Intervention Provider Agency (Licence: CA OT4310) | |
| 252Y00000X Early Intervention Provider Agency (Licence: CA OT6386) | |
| 252Y00000X Early Intervention Provider Agency (Licence: CA SP11393) | |
| 252Y00000X Early Intervention Provider Agency (Licence: SP15963) | |
| 252Y00000X Early Intervention Provider Agency (Licence: CA PT32974) | |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2012-12-14 |