Individual
GINA COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, OTR/L
Contact information
Practice address
1222 E SYCAMORE AVE, EL SEGUNDO, CA 90245-3262
(310) 322-8610
Mailing address
1222 E SYCAMORE AVE, EL SEGUNDO, CA 90245-3262
(310) 322-8610
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT 4054
CA
225XP0200X
Pediatric Occupational Therapist
Primary
OT 4054
CA
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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