Tami Renee Etheridge, OTR/L
Occupational Therapist, Pediatrics in Los Angeles, CA. Individual provider (NPI-1).
NPI number1780980409
StatusActive
Last updated in NPPESJan 27, 2011
Details
- NPI
- 1780980409
- Entity type
- Individual (NPI-1)
- Name
- Tami Renee Etheridge
- Credential
- OTR/L
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 27, 2011
- Last updated
- Jan 27, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225XP0200X | Occupational Therapist, Pediatrics | 11583 | CA | Yes |
Practice location
8717 Venice BlvdLos Angeles, CA 90034-3216
Phone 310-337-7115
Mailing address
8717 Venice BlvdLos Angeles, CA 90034-3216
Phone 310-337-7115
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