Individual
MRS. TERRY MILFORD WELLBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
200 W SANTA ANA BLVD, SANTA ANA, CA 92701-4134
(714) 647-0300
Mailing address
24242 LA CRESTA DR, DANA POINT, CA 92629-2561
(949) 496-3363
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
634
CA
Other
Enumeration date
06/05/2006
Last updated
07/08/2007
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