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Individual

AMY ELEANIS TIPPOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1700 ADAMS AVE STE 103, COSTA MESA, CA 92626-4865
(714) 556-2288
Mailing address
17344 SAN LUIS ST APT 4, FOUNTAIN VALLEY, CA 92708-3795
(714) 673-8528

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
03/18/2021
Last updated
03/18/2021
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