Individual
HEATHER LYNNE PENLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3124 LAKE DR APT 57, MARINA, CA 93933-2847
(916) 919-2983
Mailing address
3124 LAKE DR APT 57, MARINA, CA 93933-2847
(916) 919-2983
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5389
CA
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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