Individual
MS. LEEANN MARIE GAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
17609 VENTURA BLVD, SUITE #215, ENCINO, CA 91316-3858
(818) 530-5116
(818) 501-8325
Mailing address
17609 VENTURA BLVD, SUITE #215, ENCINO, CA 91316-3858
(818) 530-5116
(818) 501-8325
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2100
CA
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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