Individual
MRS. ANASTASIA FE DARAVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7850 MISSION CENTER CT, SUITE 100, SAN DIEGO, CA 92108-1322
(619) 578-2232
Mailing address
1130 S. WOODMAN ST, APT 14, SAN DIEGO, CA 92114
(619) 243-6183
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2660
CA
Other
Enumeration date
07/02/2014
Last updated
07/02/2014
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