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Individual

JEMMA MANUKYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
6542 GWIN RD, OAKLAND, CA 94611-1204
(401) 932-9398
Mailing address
89 NORFOLK ST, CRANSTON, RI 02910-2717
(401) 932-9398

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4779
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4779
OTHER
Enumeration date
03/18/2019
Last updated
03/18/2019
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