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Individual

MS. PENNY SUE CLEMENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.A.

Contact information

Practice address
31584 AGOURA RD # 3 BLD 10, WESTLAKE VILLAGE, CA 91361-4442
(818) 631-8541
Mailing address
31584 AGOURA RD # 3 BLD 10, WESTLAKE VILLAGE, CA 91361-4442
(818) 631-8541

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
39
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OTA 39
COTA
CA
Enumeration date
05/15/2007
Last updated
07/08/2007
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