Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XF0002X | Feeding, Eating & Swallowing | OT1509 | CA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT1509 | CA |
NPI | 1376778928 |
---|---|
Provider Name | Dr. Irene Villar |
First Address | Arcadia, CA 91006-2314 |
Second Address | Arcadia, CA 91006-2314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2009 |
Last Update Date | 27/05/2009 |