Individual
SUSANA ACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
303 MILDRED ST, PERRIS, CA 92571-2950
(951) 315-9742
Mailing address
303 MILDRED ST, PERRIS, CA 92571-2950
(951) 315-9742
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4751
CA
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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