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Individual

ALYSSA LORELLE FETTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, OTR/L

Contact information

Practice address
115 HARVARD PL, CLAREMONT, CA 91711-4734
(951) 990-1720
Mailing address
115 HARVARD PL, CLAREMONT, CA 91711-4734
(951) 990-1720

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
11554
CA

Other

Enumeration date
08/21/2012
Last updated
08/21/2012
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