Individual
MISS KIERSTEN CHIEKO SUGANO-WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
680 W WASHINGTON BL, PASADENA, CA 91103-2020
(626) 636-6723
Mailing address
680 W. WASHINGTON BLVD., PASADENA, CA 91103-2020
(626) 636-6723
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
03/13/2013
Last updated
03/13/2013
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