Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 8419 | CA |
NPI | 1013185925 |
---|---|
Provider Name | Valerie Rougeau |
First Address | Torrance, CA 90501 |
Second Address | Torrance, CA 90501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 13/02/2008 |