Individual
DEANNA VAILLANCOURT-THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
300 DOUGLAS ST, PETALUMA, CA 94952-2503
(707) 763-6887
Mailing address
1060 ELEANOR AVE, ROHNERT PARK, CA 94928-1833
(707) 843-7770
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11557
CA
Other
Enumeration date
06/19/2017
Last updated
06/19/2017
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