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Individual

CLARA MAE WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
11201 BENTON ST, DEPT OCCUPATIONAL THERAPY 117B, LOMA LINDA, CA 92357-1000
(909) 825-7084
Mailing address
PO BOX 952, CLAREMONT, CA 91711-0952
(909) 593-7086

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1383
CA

Other

Enumeration date
08/02/2006
Last updated
07/08/2007
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