Individual
JOANN SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3855 EDENHURST AVE, LOS ANGELES, CA 90039-1614
(323) 661-6523
Mailing address
3855 EDENHURST AVE, LOS ANGELES, CA 90039-1614
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13036
CA
Other
Enumeration date
10/31/2012
Last updated
10/31/2012
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