Individual
VICTORIA ROSE VAN TASSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
10431 COMMERCE ST STE A, REDLANDS, CA 92374-0110
(909) 735-7654
Mailing address
10431 COMMERCE ST STE A, REDLANDS, CA 92374-0110
(909) 735-7654
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
25662
CA
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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