Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 11736 | CA |
NPI | 1033418967 |
---|---|
Provider Name | Mrs. Lisa Jean Ferch |
First Address | Woodland Hills, CA 91367 |
Second Address | Woodland Hills, CA 91367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2011 |
Last Update Date | 07/07/2015 |