Individual
RAY LAVARIAS REOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-6625
(615) 270-6958
Mailing address
3750 W SAN JOSE AVE APT 107, FRESNO, CA 93711-6625
(626) 383-6390
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
20148
CA
225XH1300X
Human Factors Occupational Therapist
20148
CA
225XM0800X
Mental Health Occupational Therapist
Primary
20148
CA
225XN1300X
Neurorehabilitation Occupational Therapist
20148
CA
225XP0019X
Physical Rehabilitation Occupational Therapist
20148
CA
Other
Enumeration date
03/09/2021
Last updated
07/02/2024
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