Individual
CAROLYN QUE KISHIHARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
7120 N WHITNEY AVE, SUITE 102, FRESNO, CA 93720-0153
(559) 323-4831
(559) 323-4815
Mailing address
47900 WILLOW POND RD, COARSEGOLD, CA 93614-8720
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3029
CA
Other
Enumeration date
08/20/2012
Last updated
10/04/2012
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