Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1033665872 |
---|---|
Provider Name | Elle Louise Mustion |
First Address | Los Angeles, CA 90034-3216 |
Second Address | Los Angeles, CA 90034-3216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2016 |
Last Update Date | 31/08/2016 |