Individual
BENITA NA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1932 14TH ST, SANTA MONICA, CA 90404-4605
(310) 344-2276
Mailing address
4915 SAWTELLE BLVD APT 6, CULVER CITY, CA 90230-4851
(562) 489-6019
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
07/09/2022
Last updated
07/09/2022
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