Individual
DIANE VU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
9764 GARDEN GROVE BLVD, GARDEN GROVE, CA 92844-1615
(714) 420-8998
Mailing address
16375 SAN GABRIEL ST, FOUNTAIN VALLEY, CA 92708-1818
(714) 420-8998
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4326
CA
Other
Enumeration date
09/12/2018
Last updated
09/13/2018
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