Individual
ARIELLE TENAYA MARIE GOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2550 E FOOTHILL BLVD, PASADENA, CA 91107-3406
(626) 463-1021
Mailing address
2550 E FOOTHILL BLVD, PASADENA, CA 91107-3406
(818) 901-6600
(818) 901-6631
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT16754
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/08/2014
Last updated
12/27/2016
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