Individual
JENNIFER MARIE GANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
9160 MADISON AVE APT 33, FAIR OAKS, CA 95628-7719
(916) 765-0015
Mailing address
9160 MADISON AVE APT 33, FAIR OAKS, CA 95628-7719
(916) 765-0015
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1771
CA
Other
Enumeration date
01/01/2012
Last updated
01/01/2012
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