Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT6029 | CA |
Y | 225XM0800X | Mental Health |
NPI | 1992850523 |
---|---|
Provider Name | Ms. Holly Maureen Ledesma |
First Address | Hawthorne, CA 90250-3315 |
Second Address | Hawthorne, CA 90250-3315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 11/03/2021 |