| NPI | 1942801279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARINA BLACK Owner 760-799-5030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2022-02-03 |