Individual
MISAEL GALLEGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
18270 SISKIYOU RD # B, APPLE VALLEY, CA 92307-1413
(760) 991-3020
Mailing address
25755 RITTER AVE, HOMELAND, CA 92548-9280
(562) 322-2143
Taxonomy
Speciality
Code
Description
License number
State
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
Primary
7004
CA
Other
Enumeration date
11/15/2024
Last updated
11/15/2024
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