Individual
KELLY ANNE LOOMIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4650 EDENVALE AVE, LA MESA, CA 91941-5509
(714) 932-9009
Mailing address
4650 EDENVALE AVE, LA MESA, CA 91941-5509
(714) 932-9009
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9069
CA
Other
Enumeration date
11/12/2020
Last updated
01/02/2021
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