Individual
AIYANA TIETZE-DI TORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 MURRAY AVE, SAN LUIS OBISPO, CA 93405-1806
(805) 546-7600
Mailing address
12400 HIGH BLUFF DR, SAN DIEGO, CA 92130-3077
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
25284
CA
225X00000X
Occupational Therapist
Primary
61392819
WA
Other
Enumeration date
10/31/2024
Last updated
10/31/2024
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