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Individual

EDI NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSOT, OTR/L

Contact information

Practice address
7989 LA JOLLA SHORES DR, LA JOLLA, CA 92037-3301
(858) 242-2982
Mailing address
7989 LA JOLLA SHORES DR, LA JOLLA, CA 92037-3301
(858) 242-2982

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
12376
CA
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
12376
CA
225XP0200X
Pediatric Occupational Therapist
Primary
12376
CA

Other

Enumeration date
05/06/2015
Last updated
05/06/2015
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