Individual
BETHANY GREENWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
17977 WILLOW ST, HESPERIA, CA 92345-5465
(909) 835-0783
Mailing address
17977 WILLOW ST, HESPERIA, CA 92345-5465
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2107
CA
Other
Enumeration date
03/17/2011
Last updated
03/17/2011
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